Provider Demographics
NPI:1497302533
Name:WOJCIECHOWSKI, JOSEPH AIDAN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:AIDAN
Last Name:WOJCIECHOWSKI
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 MOUNT RANIER DR
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-2427
Mailing Address - Country:US
Mailing Address - Phone:724-953-6836
Mailing Address - Fax:
Practice Address - Street 1:9141 ALAKING CT STE 112
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-5049
Practice Address - Country:US
Practice Address - Phone:301-499-4655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27641225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist