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Individual

ALFRED THEODORE JACK NOWAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
6801 PARK TER STE 200, LOS ANGELES, CA 90045-1546
(310) 665-7100
Mailing address
6801 PARK TER STE 200, LOS ANGELES, CA 90045-1546
(310) 665-7100
(310) 665-7101

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
307422
CA

Other

Enumeration date
12/05/2024
Last updated
12/27/2024
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