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Individual

DONALD R WALENDZAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
2815 DUSTIN RD, OREGON, OH 43616
(419) 693-0676
(419) 693-0807
Mailing address
2815 DUSTIN RD STE B, STE B, OREGON, OH 43616-3497
(419) 693-0676
(419) 693-0807

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT06878
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000168967
ANTHEM
05
2347508
OH
Enumeration date
07/12/2006
Last updated
03/03/2011
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