MEDICARE: BRYAN WESLOWSKI M.A., P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	15663	NY
2	225100000X	Physical Therapist	12342	SC
3	225100000X	Physical Therapist	P22356	NC
4	225100000X	Physical Therapist	30304	MD

General Provider Information

NPI Number	:	1578664256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRYAN WESLOWSKI M.A., P.T.

Provider Business Mailing Address
First Line	:	39 HOSPITAL CENTER CMNS
Second Line	:
City	:	HILTON HEAD ISLAND
State	:	SC
Zip	:	29926-2837
Country	:	US
Telephone Number	:	843-689-2233
Fax Number	:	843-689-2234

Provider Business Practice Location Address
First Line	:	39 HOSPITAL CENTER CMNS
Second Line	:
City	:	HILTON HEAD ISLAND
State	:	SC
Zip	:	29926-2837
Country	:	US
Telephone Number	:	843-689-2233
Fax Number	:	843-689-2234

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	04/08/2025

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