Healthcare Provider Details

I. General information

NPI: 1205025343
Provider Name (Legal Business Name): NICOLE D ZELEK DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2007
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4194 NAFZGER DR
COLUMBUS OH
43230-8470
US

IV. Provider business mailing address

4194 NAFZGER DR
COLUMBUS OH
43230-8470
US

V. Phone/Fax

Practice location:
  • Phone: 402-643-0217
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number25546
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT.011937
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: