Provider Demographics
NPI:1235318072
Name:JOZWIAK, JONELLE
Entity Type:Individual
Prefix:
First Name:JONELLE
Middle Name:
Last Name:JOZWIAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5514 ATASCOCITA RD STE 160
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-2968
Mailing Address - Country:US
Mailing Address - Phone:281-441-5371
Mailing Address - Fax:
Practice Address - Street 1:5514 ATASCOCITA RD STE 160
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-2968
Practice Address - Country:US
Practice Address - Phone:281-441-5371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1168249225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist