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General NPI Number Information
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NPI Number | 1831759059
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Entity Type | Individual
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Provider Name | KEVIN WILLIAM TRUSZKOWSKI L.M.T. (LICENSE MASS
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Gender | Male
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Dates
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Enumeration Date | 06/19/2019
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Last Update Date | 06/19/2019
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Provider Practice Location Address
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Address Line | 173 SHENKEL ROAD
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City | EFFORT
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State | PA
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Zip | 18330-9044
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Country | US
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Telephone | 610-217-3702
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 210
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City | SAYLORSBURG
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State | PA
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Zip | 18353-0210
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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 | MSG004969
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 18KT00703900
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License Number State | NJ
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