Healthcare Provider Details

I. General information

NPI: 1336473339
Provider Name (Legal Business Name): JOHN JOSEPH WOJNARSKI MSPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2009
Last Update Date: 09/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BERWICK RD
ORANGEVILLE PA
17859-9064
US

IV. Provider business mailing address

107 KARL DR
SHAVERTOWN PA
18708-8012
US

V. Phone/Fax

Practice location:
  • Phone: 570-683-8511
  • Fax:
Mailing address:
  • Phone: 570-674-0744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT016363
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: