Individual
MR. JACEK WLADYSLAW MENDALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1866 W 85TH AVE, APT. J 275, MERRILLVILLE, IN 46410-8478
(219) 793-9902
Mailing address
3110 N MILWAUKEE AVE, APT.3F, CHICAGO, IL 60618-6622
(121) 979-3990
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05007301A
IN
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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