| Niccole J Mack, DPT | |
|
901 4th St Nw, Watertown, SD 57201-1558 | |
| (605) 886-8471 | |
| (605) 886-9317 |
| Full Name | Niccole J Mack |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist In Private Practice |
| Experience | 23 Years |
| Location | 901 4th St Nw, Watertown, South Dakota |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063401503 | NPI | - | NPPES |
| 5834040 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 1225 (South Dakota) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Sanford Medical Center | 8325950215 | 750 |
| Provider Name | Sanford Clinic |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1396764254 PECOS PAC ID: 0244143824 Enrollment ID: O20031110000532 |
| Provider Name | Sanford Medical Center |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1093090342 PECOS PAC ID: 8325950215 Enrollment ID: O20040115000388 |
| Mailing Address | Practice Location Address |
|---|---|
| Niccole J Mack, DPT Po Box 5074, Sioux Falls, SD 57117-5074 Ph: (605) 328-6585 | Niccole J Mack, DPT 901 4th St Nw, Watertown, SD 57201-1558 Ph: (605) 886-8471 |
Kris Cleveland, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 810 S Maple, Watertown, SD 57201 Phone: 605-753-5400 | |
Regan Rozell, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 901 14th Ave Ne, Watertown, SD 57201 Phone: 605-954-4264 | |
Stephanie L Lenards, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1516 4th St Ne, Watertown, SD 57201 Phone: 605-753-0430 | |
Josslyn Rieffenberger, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 8 5th St Se, Watertown, SD 57201 Phone: 605-753-5400 | |
Casey Grimsrud, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 901 4th St Nw, Watertown, SD 57201 Phone: 605-886-8471 Fax: 605-886-9317 | |
Mr. Nathan Lee Breske, DPT, ATC Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1516 4th St Ne, Watertown, SD 57201 Phone: 605-753-0430 Fax: 605-753-2663 |