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General NPI Number Information
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NPI Number | 1093136756
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Entity Type | Individual
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Provider Name | KATHRYN DZIUNYCZ ATC
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Gender | Female
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Dates
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Enumeration Date | 12/26/2013
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Last Update Date | 12/26/2013
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Provider Practice Location Address
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Address Line | 134 BARREN RD
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City | MEDIA
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State | PA
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Zip | 19063-4505
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Country | US
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Telephone | 610-627-6233
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Fax |
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Provider Business Mailing Address
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Address Line | 315 MAPLE ST
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City | DOWNINGTOWN
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State | PA
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Zip | 19335-3105
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Country | US
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Telephone | 484-288-0239
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | RTO000034
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License Number State | PA
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