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General NPI Number Information
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NPI Number | 1538436456
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Entity Type | Individual
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Provider Name | BRIAN ZANDARSKI LPTA
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Gender | Male
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Dates
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Enumeration Date | 11/21/2011
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 3920 W PARK AVE
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City | ORANGE
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State | TX
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Zip | 77630-1756
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Country | US
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Telephone | 409-920-4105
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Fax |
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Provider Business Mailing Address
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Address Line | 339 E MAPLE ST
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City | NORTH CANTON
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State | OH
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Zip | 44720-2593
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | A5197
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License Number State | NC
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