Organization
JMK PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARIA DAVA PT (PHYSICAL THERAPY)
(219) 308-3050
Entity
Organization
Contact information
Practice address
1201 W 96TH PL, CROWN POINT, IN 46307-1736
(219) 308-3050
Mailing address
1201 W 96TH PL, CROWN POINT, IN 46307-1736
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
05005489A
IN
225100000X
Physical Therapist
Primary
05007718A
IN
225100000X
Physical Therapist
05009224A
IN
Other
Enumeration date
04/14/2010
Last updated
04/14/2010
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