Organization
RISE ORTHOPEDIC AND SPORTS PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK ANDREW JAGODZINSKI PT (OWNER)
(623) 234-4171
Entity
Organization
Contact information
Practice address
12515 W BELL RD SUITE 103, SURPRISE, AZ 85378-3801
(623) 234-4171
(623) 234-4173
Mailing address
12515 W BELL RD SUITE 103, SURPRISE, AZ 85378-3801
(623) 234-4171
(623) 234-4173
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
5576
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
738692
—
AZ
Enumeration date
10/16/2017
Last updated
06/26/2023
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