Provider Demographics
NPI:1306214291
Name:STAWECKI, MARK (DPT)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:STAWECKI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:438 PELLIS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-7900
Mailing Address - Country:US
Mailing Address - Phone:724-850-7587
Mailing Address - Fax:724-850-8329
Practice Address - Street 1:520 PELLIS RD
Practice Address - Street 2:SUITE 1000
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-4777
Practice Address - Country:US
Practice Address - Phone:724-838-1008
Practice Address - Fax:724-832-1690
Is Sole Proprietor?:No
Enumeration Date:2015-09-09
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAPT61171761225100000X
PAPT024675225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist