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Individual
MR. THADDEUS MACKIEWICZ JR.
Active
Individual
MR. THADDEUS MACKIEWICZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6085
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0465875
CIGNA
TN
05
—
36583521
—
TN
01
—
4140561
BLUECROSS BLUESHIELD
TN
Enumeration date
05/16/2006
Last updated
04/22/2013
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