Provider Demographics
NPI:1720036510
Name:JKM PHYSICAL THERAPY, P.C.
Entity Type:Organization
Organization Name:JKM PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BERNERD
Authorized Official - Last Name:MARKWICA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:518-306-4268
Mailing Address - Street 1:18 CASTLEBERRY DR
Mailing Address - Street 2:
Mailing Address - City:GANSEVOORT
Mailing Address - State:NY
Mailing Address - Zip Code:12831-2531
Mailing Address - Country:US
Mailing Address - Phone:518-306-4268
Mailing Address - Fax:
Practice Address - Street 1:18 CASTLEBERRY DR
Practice Address - Street 2:
Practice Address - City:GANSEVOORT
Practice Address - State:NY
Practice Address - Zip Code:12831-2531
Practice Address - Country:US
Practice Address - Phone:518-306-4268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy