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NPI Code Detail

MEDICARE: ELIZABETH KOCHANOWSKI DPT

MEDICARE: ELIZABETH KOCHANOWSKI 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
1225100000XPhysical Therapist11925CT
2225100000XPhysical TherapistLPT-31032AZ

General Provider Information

NPI Number : 1558842310
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH KOCHANOWSKI DPT
Provider Business Mailing Address
First Line : 13625 S 48TH ST APT 1118
Second Line :
City : PHOENIX
State : AZ
Zip : 85044-5051
Country : US
Telephone Number : 860-734-3036
Fax Number :
Provider Business Practice Location Address
First Line : 746 W GUADALUPE RD
Second Line :
City : GILBERT
State : AZ
Zip : 85233-3200
Country : US
Telephone Number : 480-645-9310
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2018
Last Update Date : 08/01/2022

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