Provider Demographics
NPI:1962665133
Name:ZOVKO, CARL J (PT)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:J
Last Name:ZOVKO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7850 ROCKFISH VALLEY HWY
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:VA
Mailing Address - Zip Code:22920-3189
Mailing Address - Country:US
Mailing Address - Phone:434-989-9767
Mailing Address - Fax:
Practice Address - Street 1:7850 ROCKFISH VALLEY HWY
Practice Address - Street 2:
Practice Address - City:AFTON
Practice Address - State:VA
Practice Address - Zip Code:22920-3189
Practice Address - Country:US
Practice Address - Phone:434-989-9767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA390200000X
VA2305205547225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program