MEDICARE: ERIK ZAMBONI DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	4226	OR

General Provider Information

NPI Number	:	1003951948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIK ZAMBONI DPT

Provider Business Mailing Address
First Line	:	1558 SW NANCY WAY
Second Line	:	SUITE 104
City	:	BEND
State	:	OR
Zip	:	97702-3216
Country	:	US
Telephone Number	:	541-312-2004
Fax Number	:

Provider Business Practice Location Address
First Line	:	1558 SW NANCY WAY
Second Line	:	SUITE 104
City	:	BEND
State	:	OR
Zip	:	97702-3216
Country	:	US
Telephone Number	:	541-312-2004
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	07/08/2007

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Directions to “ ERIK ZAMBONI DPT” Practice Location

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