Provider Demographics
NPI:1295258267
Name:CZARNECKI, JANICE LOUISE (PT)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:LOUISE
Last Name:CZARNECKI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17723 MAPLE HILL DR
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-3236
Mailing Address - Country:US
Mailing Address - Phone:586-839-1444
Mailing Address - Fax:
Practice Address - Street 1:6020 W MAPLE RD STE 500
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-4409
Practice Address - Country:US
Practice Address - Phone:248-851-6999
Practice Address - Fax:248-851-6898
Is Sole Proprietor?:No
Enumeration Date:2017-07-21
Last Update Date:2017-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist