Healthcare Provider Details

I. General information

NPI: 1124741681
Provider Name (Legal Business Name): KATARZYNA JUSTYNA ZAZEL-WOLSKA PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2022
Last Update Date: 09/20/2022
Certification Date: 09/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1729 E HAMPTON LN
GILBERT AZ
85295-6060
US

IV. Provider business mailing address

1729 E HAMPTON LN
GILBERT AZ
85295-6060
US

V. Phone/Fax

Practice location:
  • Phone: 224-715-2344
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberLPT-32551
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: