| Jonathan Devon Mack, PT, DPT | |
|
9881 Broken Land Pkwy Ste 103, Columbia, MD 21046-3013 | |
| (301) 798-4838 | |
| Not Available |
| Full Name | Jonathan Devon Mack |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 9881 Broken Land Pkwy Ste 103, Columbia, Maryland |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295561090 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 2305215805 (Virginia) | Primary |
| Provider Name | Rehab 2 Perform Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1306251434 PECOS PAC ID: 6002199064 Enrollment ID: O20170217000052 |
| Mailing Address | Practice Location Address |
|---|---|
| Jonathan Devon Mack, PT, DPT 7300 Boulder Lake Dr Apt 1201, North Chesterfield, VA 23225-5570 Ph: (757) 641-7645 | Jonathan Devon Mack, PT, DPT 9881 Broken Land Pkwy Ste 103, Columbia, MD 21046-3013 Ph: (301) 798-4838 |
Susannah Lynn Coover, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 8885 Centre Park Dr Ste G, Columbia, MD 21045 Phone: 410-730-1275 | |
Performance Physical Therapy And Sports Rehabilitation Llc Physical Therapist Medicare: Medicare Enrolled Practice Location: 9194 Red Branch Rd Ste J, Columbia, MD 21045 Phone: 410-997-2585 Fax: 410-997-2586 | |
Mrs. Sandra L Woods, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 5500 Knoll North Dr Ste 150, Columbia, MD 21045 Phone: 443-542-0062 | |
Laura Flynn, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 11085 Little Patuxent Pkwy, Suite 207, Columbia, MD 21044 Phone: 410-884-4111 Fax: 410-884-4113 | |
Ryan Bibeau, DPT, CSCS Physical Therapist Medicare: Medicare Enrolled Practice Location: 8895 Mcgaw Rd Ste G, Columbia, MD 21045 Phone: 443-441-0616 | |
Caitlin Elaine Kratz, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 5435 Beaverkill Rd, Columbia, MD 21044 Phone: 410-740-0883 Fax: 410-740-9970 | |
Loretta Anne Merl, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 10632 Little Patuxent Pkwy, Columbia, MD 21044 Phone: 410-740-0300 |