Provider Demographics
NPI:1184191389
Name:ZUKOWSKI, LINDA M (NC LMBT #5951)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:ZUKOWSKI
Suffix:
Gender:F
Credentials:NC LMBT #5951
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8384 SIX FORKS RD STE 203
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-5089
Mailing Address - Country:US
Mailing Address - Phone:919-602-5742
Mailing Address - Fax:
Practice Address - Street 1:8384 SIX FORKS RD STE 203
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5089
Practice Address - Country:US
Practice Address - Phone:919-602-5742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5951225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist