Provider Demographics
NPI:1083135529
Name:JUREWICZ, PATRICK EUGENE (SCAT, ATC)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:EUGENE
Last Name:JUREWICZ
Suffix:
Gender:M
Credentials:SCAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 SOUTHERN DR UNIT 2108
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-5608
Mailing Address - Country:US
Mailing Address - Phone:973-897-4139
Mailing Address - Fax:
Practice Address - Street 1:1302 HEYWARD ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29208-3407
Practice Address - Country:US
Practice Address - Phone:973-897-4139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-06
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program