Individual
JACK ZYGMUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
626 TRAIL AVE, FREDERICK, MD 21701-4934
(301) 662-1997
(301) 668-2202
Mailing address
626 TRAIL AVE, FREDERICK, MD 21701-4934
(301) 662-1997
(301) 668-2202
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17841
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KBC4HO-64125101
BC/BS
MD
01
—
S404-0014
CAREFIRST
MD
Enumeration date
07/25/2006
Last updated
07/11/2008
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