Organization
SHAKAMAK REHAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVER WOLF RPH (PHARMACIST)
(812) 201-1441
Entity
Organization
Contact information
Practice address
326 E MAIN ST, JASONVILLE, IN 47438-1510
(812) 201-1441
Mailing address
346 E MAIN ST, JASONVILLE, IN 47438-1510
(812) 201-1441
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
2255A2300X
Athletic Trainer
—
—
225700000X
Massage Therapist
—
—
225X00000X
Occupational Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
12/07/2023
Last updated
12/07/2023
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