Individual
MARIUSZ WDOWIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
38 NANEL DR APT B, GLASTONBURY, CT 06033-2256
(860) 478-7583
Mailing address
38 NANEL DR APT B, GLASTONBURY, CT 06033-2256
(860) 478-7583
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
000599
CT
225200000X
Physical Therapy Assistant
20766
FL
225200000X
Physical Therapy Assistant
7392A
AZ
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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