Provider Demographics
NPI:1518942820
Name:KOLWICZ, TRICIA ANN (PT)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:ANN
Last Name:KOLWICZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-3128
Mailing Address - Country:US
Mailing Address - Phone:614-854-9959
Mailing Address - Fax:
Practice Address - Street 1:5025 BRADENTON AVE
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-3506
Practice Address - Country:US
Practice Address - Phone:614-799-0601
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH08778225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist