Healthcare Provider Details

I. General information

NPI: 1700669769
Provider Name (Legal Business Name): MALGORZATA HULACKA-TOZIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2023
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7825 BALLANTYNE COMMONS PKWY
CHARLOTTE NC
28277-3174
US

IV. Provider business mailing address

7420 N REA PARK LN APT 4313
CHARLOTTE NC
28277-6777
US

V. Phone/Fax

Practice location:
  • Phone: 866-839-6979
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP22308
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: