Provider Demographics
NPI:1255850657
Name:MICHALOWICZ, ELIZABETH ROCKWELL (PT, DPT, OCS)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ROCKWELL
Last Name:MICHALOWICZ
Suffix:
Gender:F
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:EIZABETH
Other - Middle Name:ANSTIS
Other - Last Name:ROCKWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:2300 E PINETREE BLVD
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-4825
Mailing Address - Country:US
Mailing Address - Phone:229-228-8050
Mailing Address - Fax:
Practice Address - Street 1:2300 E PINETREE BLVD
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-4825
Practice Address - Country:US
Practice Address - Phone:229-228-8050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-18
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT015405225100000X
NC17413225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist