Provider Demographics
NPI:1053713842
Name:CZERWINSKI, RYSZARD (RPT)
Entity type:Individual
Prefix:
First Name:RYSZARD
Middle Name:
Last Name:CZERWINSKI
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 COURT ST
Mailing Address - Street 2:
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661-9387
Mailing Address - Country:US
Mailing Address - Phone:989-345-1126
Mailing Address - Fax:989-345-4752
Practice Address - Street 1:575 COURT ST
Practice Address - Street 2:
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661-9387
Practice Address - Country:US
Practice Address - Phone:989-345-1126
Practice Address - Fax:989-345-4752
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501011451225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist