Provider Demographics
NPI:1649566472
Name:MROCZKOWSKI, STEFAN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:STEFAN
Middle Name:
Last Name:MROCZKOWSKI
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 1:1450 FIRESTONE PKWY
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44301-1655
Mailing Address - Country:US
Mailing Address - Phone:330-724-3345
Mailing Address - Fax:
Practice Address - Street 1:1450 FIRESTONE PKWY
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44301-1655
Practice Address - Country:US
Practice Address - Phone:330-724-3345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.011929225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist