Ken Mack, PTA

NPI #1083926158 in South Bend, Indiana

Provider Information

NPI Number: 1083926158
Entity Type: Individual
Name: Ken Mack, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Jul 6, 2010
Last Updated: Jul 6, 2010

Practice Location

Address: 1005 N HICKORY RD
City: South Bend
State: Indiana
ZIP Code: 46615-3723
Phone: (574) 233-5754

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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