Individual
TOMASZ ZYWICKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1419 S EMPIRE WAY, BOISE, ID 83709-2128
(208) 284-0619
Mailing address
1419 S EMPIRE WAY, BOISE, ID 83709-2128
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-2556
ID
Other
Enumeration date
11/23/2012
Last updated
11/23/2012
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