Jennifer Polke, L.M.T.

Individual provider Active NPI Mechanotherapist · Vandergrift, PA

NPI 1639619778 · NPPES record last updated Mar 7, 2017

Key facts

NPI
1639619778
Entity type
Individual (NPI type 1)
Primary specialty
Mechanotherapist 172M00000X
License
010165 (PA)
Practice address
1161 Jane St
Vandergrift, PA 15690-6106
Phone
(412) 498-5163
NPI assigned
Mar 7, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
010165PAMDMechanotherapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mechanotherapist 172M00000X 010165 PA Yes

Addresses

Primary practice location

1161 Jane St
Vandergrift, PA 15690-6106

Mailing address

1161 Jane St
Vandergrift, PA 15690-6106
Phone (412) 498-5163

Other providers in Vandergrift, PA

All providers in Vandergrift, PA · Mechanotherapist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.