Provider Demographics
NPI:1952484529
Name:FIJALKOWSKI, HENRY MICHAEL (ATC)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:MICHAEL
Last Name:FIJALKOWSKI
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:281 ROCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17551-9738
Mailing Address - Country:US
Mailing Address - Phone:717-871-1085
Mailing Address - Fax:
Practice Address - Street 1:105 PUCILLO DR
Practice Address - Street 2:MILLERSVILLE UNIVERSITY
Practice Address - City:MILLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17551
Practice Address - Country:US
Practice Address - Phone:717-872-3870
Practice Address - Fax:717-871-2449
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART000119A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer