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General NPI Number Information
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NPI Number | 1093715765
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Entity Type | Individual
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Provider Name | JOSEPH HENRY NOWAK P.T., D.P.T.
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Gender | Male
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Dates
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Enumeration Date | 07/26/2005
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Last Update Date | 10/28/2015
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Provider Practice Location Address
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Address Line | 1385 E GARRISON BLVD
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City | GASTONIA
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State | NC
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Zip | 28054-5127
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Country | US
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Telephone | 704-864-4424
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Fax | 704-864-2125
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Provider Business Mailing Address
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Address Line | 640 SUMMIT CROSSING PLACE #208
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City | GASTONIA
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State | NC
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Zip | 28054
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Country | US
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Telephone | 704-671-5730
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Fax | 704-671-5750
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 9298
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License Number State | NC
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