Provider Demographics
NPI:1689421323
Name:KIERMAS, JEFF (PT)
Entity type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:KIERMAS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 E OAK ST
Mailing Address - Street 2:
Mailing Address - City:LAKE IN THE HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60156-6176
Mailing Address - Country:US
Mailing Address - Phone:847-766-0011
Mailing Address - Fax:847-999-6722
Practice Address - Street 1:700 E OAK ST
Practice Address - Street 2:
Practice Address - City:LAKE IN THE HILLS
Practice Address - State:IL
Practice Address - Zip Code:60156-6176
Practice Address - Country:US
Practice Address - Phone:847-766-0011
Practice Address - Fax:847-999-6722
Is Sole Proprietor?:No
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist