Provider Demographics
NPI:1912281296
Name:MACDOW, ZITA
Entity Type:Individual
Prefix:
First Name:ZITA
Middle Name:
Last Name:MACDOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2212 ABBOTTWOODS LN
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-9214
Mailing Address - Country:US
Mailing Address - Phone:509-619-4945
Mailing Address - Fax:
Practice Address - Street 1:1595 LONG ISLAND DR
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7264
Practice Address - Country:US
Practice Address - Phone:509-619-4945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR269012225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist