National Provider Identifier
Mark Jaeckle, PT
Mark Jaeckle, PT is listed in the NPPES registry with a primary specialty of Physical Therapist in Orchard Park, NY and a listed phone number of (716) 481-9044.
Profile Overview
- NPI
- 1932978764
- Provider Type
- Individual
- Primary Specialty
- Physical Therapist
- Enumeration Date
- December 20, 2023
- Last Updated
- December 20, 2023
Practice Location
- 145 Stoughton Ln
- Orchard Park, NY 14127-2086
Phone: (716) 481-9044
Specialties
- Physical Therapist (225100000X)
Full Record
- NPI
- 1932978764
- Entity Type
- Individual
- Last Name
- Jaeckle
- First Name
- Mark
- Credential
- PT
- Mailing Street Address
- 145 Stoughton Ln
- Mailing City
- Orchard Park
- Mailing State
- NY
- Mailing ZIP Code
- 14127-2086
- Mailing Country
- US
- Mailing Phone
- (716) 481-9044
- Practice Street Address
- 145 Stoughton Ln
- Practice City
- Orchard Park
- Practice State
- NY
- Practice ZIP Code
- 14127-2086
- Practice Country
- US
- Practice Phone
- (716) 481-9044
- Enumeration Date
- December 20, 2023
- Last Updated
- December 20, 2023
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- December 20, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physical Therapist (225100000X)