| Mrs Kathryn Elizabeth Jacques, MPT | |
|
Corner Of Route N12 And N7, Fort Defiance, AZ 86504 | |
| (928) 729-8132 | |
| Not Available |
| Full Name | Mrs Kathryn Elizabeth Jacques |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | Corner Of Route N12 And N7, Fort Defiance, Arizona |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245470210 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PHYP2898 (Alaska) | Primary |
| Provider Name | Alaska Native Tribal Health Consortium |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1437189339 PECOS PAC ID: 6709780265 Enrollment ID: O20031125000772 |
| Provider Name | Southcentral Foundation |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1780614263 PECOS PAC ID: 5496663627 Enrollment ID: O20051027000416 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Kathryn Elizabeth Jacques, MPT 4201 Tudor Centre Dr, Anchorage, AK 99508-5914 Ph: (907) 729-3300 | Mrs Kathryn Elizabeth Jacques, MPT Corner Of Route N12 And N7, Fort Defiance, AZ 86504 Ph: (928) 729-8132 |
Sarah Maria Berkenstock, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: N7, Corner Of Routes N12, Fort Defiance, AZ 86504 Phone: 928-729-8000 | |
Robbie Whitehair, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: Corner Of Route N12 And N7, Fort Defiance Indian Hospital Board, Inc., Fort Defiance, AZ 86504 Phone: 928-729-8810 | |
Dr. Jonathan Thomas Keown, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: Corner Of Route N12 And N7, Fort Defiance, AZ 86504 Phone: 928-729-8000 | |
Miss Deidrea Rose Salabye, P.T. Physical Therapist Medicare: Medicare Enrolled Practice Location: Corner Of Route N12 And N7, Fort Defiance, AZ 86504 Phone: 928-729-8000 Fax: 928-729-8814 | |
Ms. Alana Marie Bencivengo, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: Corner Of Route 12 And 7, Fort Defiance, AZ 86504 Phone: 928-729-8000 | |
Derek Andrew Ray, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: Corner Of Route N12 And N7, Fort Defiance, AZ 86504 Phone: 928-729-8000 |