Healthcare Provider Details

I. General information

NPI: 1861458549
Provider Name (Legal Business Name): JAWORSKI PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 WINCKLES STREET
ELYRIA OH
44035
US

IV. Provider business mailing address

137 WINCKLES STREET
ELYRIA OH
44035
US

V. Phone/Fax

Practice location:
  • Phone: 440-366-5993
  • Fax: 440-366-5313
Mailing address:
  • Phone: 440-366-5993
  • Fax: 440-366-5313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateOH

VIII. Authorized Official

Name: MR. MICHAEL J JAWORSKI
Title or Position: PRESIDENT
Credential: PT
Phone: 440-366-5993