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General NPI Number Information
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NPI Number | 1689539843
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Entity Type | Individual
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Provider Name | ADRIAN GONCERZEWICZ
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Gender | Male
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Dates
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Enumeration Date | 12/19/2025
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 1424 MOLALLA AVE
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City | OREGON CITY
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State | OR
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Zip | 97045-4004
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Country | US
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Telephone | 503-744-4916
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Fax |
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Provider Business Mailing Address
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Address Line | 58 FAIRWAY DR
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City | NEWNAN
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State | GA
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Zip | 30265-5634
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT016609
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License Number State | GA
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