Provider Demographics
NPI:1730294349
Name:MIDZAK, OLGA ANNA (MPT)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:ANNA
Last Name:MIDZAK
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:888 FOX CHASE RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:ROCKLEDGE
Mailing Address - State:PA
Mailing Address - Zip Code:19046-4437
Mailing Address - Country:US
Mailing Address - Phone:215-663-8050
Mailing Address - Fax:215-663-9388
Practice Address - Street 1:888 FOX CHASE RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ROCKLEDGE
Practice Address - State:PA
Practice Address - Zip Code:19046-4437
Practice Address - Country:US
Practice Address - Phone:215-663-8050
Practice Address - Fax:215-663-9388
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT003674-L2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic