| Jack Burg, | |
|
1048 N Monroe St, Monroe, MI 48162-3113 | |
| (734) 241-1400 | |
| Not Available |
| Full Name | Jack Burg |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 1048 N Monroe St, Monroe, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104604305 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 5501302987 (Michigan) | Primary |
| Provider Name | Benchmark Physical Therapy Michigan Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1629740188 PECOS PAC ID: 4880087766 Enrollment ID: O20220217001560 |
| Mailing Address | Practice Location Address |
|---|---|
| Jack Burg, 1200 Corporate Dr Ste 400, Hoover, AL 35242-5424 Ph: () - | Jack Burg, 1048 N Monroe St, Monroe, MI 48162-3113 Ph: (734) 241-1400 |
Jana Christine Ruddy, PT - PHYSICAL THERAP Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 407 S. Telegraph Rd., Monroe, MI 48161 Phone: 734-240-1950 Fax: 734-240-1955 | |
Dr. Katelyn E Grau, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 700 Stewart Rd, Monroe, MI 48162 Phone: 734-240-1820 | |
Mrs. Malgorzata Agnieszka Latala, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1038 N Monroe St, Monroe, MI 48162 Phone: 734-242-0101 | |
Ronald D Mashni, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1291 N Telegraph Rd, Monroe, MI 48162 Phone: 734-243-0300 Fax: 734-243-3066 | |
Mr. Bradly Todd Davis, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 407 S Telegraph Rd, Monroe, MI 48161 Phone: 734-240-1950 | |
Barbara Mcneil, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 407 S Telegraph Rd, Monroe, MI 48161 Phone: 734-240-1950 Fax: 734-240-1955 |