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General NPI Number Information
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NPI Number | 1447776562
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Entity Type | Individual
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Provider Name | MALGORZATA MLYNARCZYK
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Gender | Female
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Dates
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Enumeration Date | 08/21/2017
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Last Update Date | 08/21/2017
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Provider Practice Location Address
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Address Line | 105 FORREST AVE STE 100
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City | NARBERTH
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State | PA
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Zip | 19072-2232
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Country | US
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Telephone | 610-668-1828
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Fax |
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Provider Business Mailing Address
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Address Line | 3359 MERCER ST
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City | PHILADELPHIA
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State | PA
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Zip | 19134-5322
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Country | US
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Telephone |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MSG010399
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License Number State | PA
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