Provider Demographics
NPI:1528572286
Name:SYDZYIK, MARY THERESE (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:THERESE
Last Name:SYDZYIK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7804 WOODSTONE LN
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66217-9619
Mailing Address - Country:US
Mailing Address - Phone:913-633-9953
Mailing Address - Fax:
Practice Address - Street 1:10730 NALL AVE STE 200
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1285
Practice Address - Country:US
Practice Address - Phone:913-574-1460
Practice Address - Fax:913-574-1496
Is Sole Proprietor?:No
Enumeration Date:2017-11-16
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-02467225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist