Provider Demographics
NPI:1609026020
Name:NOWAK, LECH (LMT)
Entity Type:Individual
Prefix:MR
First Name:LECH
Middle Name:
Last Name:NOWAK
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 NE 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-6303
Mailing Address - Country:US
Mailing Address - Phone:954-658-4022
Mailing Address - Fax:954-636-5872
Practice Address - Street 1:1800 N FEDERAL HWY
Practice Address - Street 2:SUITE 203
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1034
Practice Address - Country:US
Practice Address - Phone:954-545-1323
Practice Address - Fax:954-545-1325
Is Sole Proprietor?:No
Enumeration Date:2008-09-22
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 35259225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist