Mckale Mikolajczak, DPT | |
1551 Renaissance Towne Dr Ste 350, Bountiful, UT 84010-7674 | |
(801) 295-3553 | |
(801) 295-3599 |
Full Name | Mckale Mikolajczak |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 1551 Renaissance Towne Dr Ste 350, Bountiful, Utah |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1427795541 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 12835857-2401 (Utah) | Primary |
Provider Name | Performance West Physical Therapy |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1720148240 PECOS PAC ID: 4789649047 Enrollment ID: O20041129000296 |
Provider Name | University Of Utah |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1588656870 PECOS PAC ID: 0749262665 Enrollment ID: O20050629000441 |
Mailing Address | Practice Location Address |
---|---|
Mckale Mikolajczak, DPT 1551 Renaissance Towne Dr Ste 350, Bountiful, UT 84010-7674 Ph: (801) 295-3553 | Mckale Mikolajczak, DPT 1551 Renaissance Towne Dr Ste 350, Bountiful, UT 84010-7674 Ph: (801) 295-3553 |
Jaren Weber, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 74 E 500 S Ste 104, Bountiful, UT 84010 Phone: 801-292-5011 | |
Mr. Robert Allen Hawkes, MSPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1551 S Renaissance Twn Dr, Suite 420 Sportsmed Physical Therapy, Bountiful, UT 84010 Phone: 801-295-8999 Fax: 801-292-4168 | |
Jessica Elizabeth Sherman, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 280 N Main St, Bountiful, UT 84010 Phone: 801-397-8700 | |
Michael Carl Warren, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 74 E 500 S Ste 104, Bountiful, UT 84010 Phone: 801-292-5011 Fax: 801-292-8222 | |
Jessie Balicki, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 523 N Main St, Bountiful, UT 84010 Phone: 801-951-2273 | |
Mr. Robert J Larsen, MPT ATG Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1551 S Renaissance Twn Dr, Suite 420, Bountiful, UT 84010 Phone: 801-295-8999 Fax: 801-292-4168 | |
Mrs. Stephanie Jackson, D.P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1551 Renaissance Towne Dr Ste 350, Bountiful, UT 84010 Phone: 801-295-3553 Fax: 801-295-3599 |