Dr. Mark Andrew Jagodzinski, PT
Physical Therapist, Orthopedic in Surprise, AZ. Individual provider (NPI-1).
NPI number1891732467
StatusActive
Last updated in NPPESJan 17, 2023
Details
- NPI
- 1891732467
- Entity type
- Individual (NPI-1)
- Name
- Dr. Mark Andrew Jagodzinski
- Credential
- PT
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 1, 2006
- Certification date
- Jan 17, 2023
- Last updated
- Jan 17, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2251X0800X | Physical Therapist, Orthopedic | 5576 | AZ | Yes |
| 225100000X | Physical Therapist | 5576 | AZ | |
| 2251G0304X | Physical Therapist, Geriatrics | 5576 | AZ | |
| 2251H1200X | Physical Therapist, Hand | 5576 | AZ | |
| 2251P0200X | Physical Therapist, Pediatrics | 5576 | AZ | |
| 2251S0007X | Physical Therapist, Sports | 5576 | AZ |
Practice location
12515 W Bell Rd Ste 103Surprise, AZ 85378-9701
Phone 623-234-4171 · Fax 623-234-4173
Mailing address
12515 W Bell Rd Ste 103Surprise, AZ 85378-9701
Phone 623-234-4171 · Fax 623-234-4173
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