Organization
OLYMPIC REHAB CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAREK W PIATKOWSKI-NAZARRO (PHYSICAL THERAPIST)
(323) 204-8797
Entity
Organization
Contact information
Practice address
1314 W GLENOAKS BLVD, SUITE 204, GLENDALE, CA 91201-3146
(818) 204-8797
Mailing address
1314 W GLENOAKS BLVD, SUITE 204, GLENDALE, CA 91201-3146
(818) 204-8797
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT15084
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT15084
PT
CA
Enumeration date
05/26/2011
Last updated
12/22/2011
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