Provider Demographics
NPI:1356566772
Name:ZAWADZKE, CALIE R (MSPT)
Entity type:Individual
Prefix:
First Name:CALIE
Middle Name:R
Last Name:ZAWADZKE
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16527 MARBLE RDG
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-9097
Mailing Address - Country:US
Mailing Address - Phone:260-637-5656
Mailing Address - Fax:260-637-5656
Practice Address - Street 1:16527 MARBLE RDG
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845-9097
Practice Address - Country:US
Practice Address - Phone:260-637-5656
Practice Address - Fax:260-637-5656
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05003500A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist