Individual
DR. MARK ANDREW JAGODZINSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
12515 W BELL RD STE 103, SURPRISE, AZ 85378-9701
(623) 234-4171
(623) 234-4173
Mailing address
12515 W BELL RD STE 103, SURPRISE, AZ 85378-9701
(623) 234-4171
(623) 234-4173
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5576
AZ
2251G0304X
Geriatric Physical Therapist
5576
AZ
2251H1200X
Hand Physical Therapist
5576
AZ
2251P0200X
Pediatric Physical Therapist
5576
AZ
2251S0007X
Sports Physical Therapist
5576
AZ
2251X0800X
Orthopedic Physical Therapist
Primary
5576
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
738792
—
AZ
Enumeration date
06/01/2006
Last updated
01/17/2023
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