Basic Information
Provider Information
NPI: 1184278285
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VOJTEK
FirstName: PAUL
MiddleName:  
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Credential:  
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Mailing Information
Address1: 1200 CORPORATE DR STE 400
Address2:  
City: BIRMINGHAM
State: AL
PostalCode: 352425424
CountryCode: US
TelephoneNumber: 4235415491
FaxNumber: 4235516278
Practice Location
Address1: 1424 HIGHWAY 17 N STE 2
Address2:  
City: NORTH MYRTLE BEACH
State: SC
PostalCode: 295822507
CountryCode: US
TelephoneNumber: 8434277132
FaxNumber: 8434277154
Other Information
ProviderEnumerationDate: 07/26/2019
LastUpdateDate: 07/26/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X SCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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