Individual
STEVEN ALEXANDER WIETRZYKOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT, CSCS
Contact information
Practice address
4650 NW 39TH PLACE, SUITE A, GAINESVILLE, FL 32606
(352) 225-3610
Mailing address
5418 SW 4TH PL, GAINESVILLE, FL 32607-2013
(419) 764-3427
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
PT33590
FL
2251X0800X
Orthopedic Physical Therapist
Primary
PT33590
FL
Other
Enumeration date
02/06/2019
Last updated
02/06/2019
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