Organization
MCDONALD PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRANCIS JOSEPH MCDONALD D.P.T. (PRESIDENT/CEO)
(574) 233-5754
Entity
Organization
Contact information
Practice address
1005 N HICKORY RD, SOUTH BEND, IN 46615-3723
(574) 233-5754
(574) 233-7406
Mailing address
1005 N HICKORY RD, SOUTH BEND, IN 46615-3723
(574) 233-5754
(574) 233-7406
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
53000037
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100351040A
—
IN
01
—
266690
MEDICARE PART B- PTAN
IN
Enumeration date
07/06/2005
Last updated
08/28/2013
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