MEDICARE: MR. MARK GEORGE ZAJAC SR. P.T.

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	24066	MA
2	225100000X	Physical Therapist	CP044333T	SC
3	225100000X	Physical Therapist	2153	NH

General Provider Information

NPI Number	:	1528037934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARK GEORGE ZAJAC SR. P.T.

Provider Business Mailing Address
First Line	:	10 BURNSIDE ST
Second Line	:
City	:	LANCASTER
State	:	NH
Zip	:	03584-3242
Country	:	US
Telephone Number	:	603-616-8644
Fax Number	:

Provider Business Practice Location Address
First Line	:	890 WILLIAM HILTON PKWY STE 108-C
Second Line	:
City	:	HILTON HEAD
State	:	SC
Zip	:	29928-3418
Country	:	US
Telephone Number	:	843-705-2572
Fax Number	:

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

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	11/04/2025

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