Healthcare Provider Details

I. General information

NPI: 1780470906
Provider Name (Legal Business Name): JOSEPHINE VIRGINIA WOJTKOWIAK DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

2850 W HORIZON RIDGE PKWY
HENDERSON NV
89052-4395
US

IV. Provider business mailing address

2850 W HORIZON RIDGE PKWY
HENDERSON NV
89052-4395
US

V. Phone/Fax

Practice location:
  • Phone: 702-564-4116
  • Fax:
Mailing address:
  • Phone: 702-564-4116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number6663
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: