MICHAEL JACKETTA, MPT, OCS

Physical Therapist

Active Individual
NPI: 1134131055

Practice Address

620 WEST CHEYENNE DRIVE
Evanston, WY 82930

Phone: (307) 789-8860

Specialties

Specialty Code Primary License
Physical Therapist 225100000X Yes 840 (WY)

Frequently Asked Questions

NPI 1134131055 is the National Provider Identifier for MICHAEL JACKETTA, MPT, OCS, a Physical Therapist provider located in Evanston, WY. This NPI was enumerated on August 12, 2006.
MICHAEL JACKETTA, MPT, OCS practices at 620 WEST CHEYENNE DRIVE, Evanston, WY 82930.

Quick Facts

NPI
1134131055
Type
Individual
Enumerated
Aug 12, 2006
Last Updated
Jul 8, 2007

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