Provider Demographics
NPI:1386220812
Name:JANK, PHILLIP (DPT)
Entity type:Individual
Prefix:
First Name:PHILLIP
Middle Name:
Last Name:JANK
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 E LOVEJOY ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14206-1033
Mailing Address - Country:US
Mailing Address - Phone:716-892-8811
Mailing Address - Fax:716-892-3888
Practice Address - Street 1:1002 E LOVEJOY ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14206-1033
Practice Address - Country:US
Practice Address - Phone:716-892-8811
Practice Address - Fax:716-892-3888
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist