MEDICARE: ROXANNE MAZURKIEWICZ PT, 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	PT35982	FL
2	225100000X	Physical Therapist	1247968	TX

General Provider Information

NPI Number	:	1093565285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROXANNE MAZURKIEWICZ PT, DPT

Provider Business Mailing Address
First Line	:	3909 N LOOP 288 APT 8308
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76208-7131
Country	:	US
Telephone Number	:	469-744-4024
Fax Number	:

Provider Business Practice Location Address
First Line	:	3909 N LOOP 288 APT 8308
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76208-7131
Country	:	US
Telephone Number	:	469-744-4024
Fax Number	:

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

Provider Enumeration Date	:	03/22/2024
Last Update Date	:	03/22/2024

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Directions to “ ROXANNE MAZURKIEWICZ PT, DPT” Practice Location

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