CHRIS JACK PTA MT NPI 1992317051

NPI Information

NPI: 1992317051
Provider Name: CHRIS JACK, PTA, MT
Classification: Massage Therapist - 225700000X
Entity Type: Individual
Address:
1781 E LINCOLN RD
KOKOMO, IN
ZIP 46902
Phone: (765) 455-2014
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Chris Jack, PTA, MT is a massage therapist in Kokomo, IN. The provider is an individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. Chris Jack, PTA, MT NPI is 1992317051. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1781 E LINCOLN RD
KOKOMO, IN
ZIP 46902-993
Phone: (765) 455-2014
Fax: (765) 455-6099

The enumeration date for this NPI number is 8/20/2020 and was last updated on 8/20/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225700000X	Massage Therapist		MT20901752	INDIANA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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