Basic Information
| Provider Information | |||||||||
| NPI: | 1245370188 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | WOSIAK | ||||||||
| FirstName: | EWELINA | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8259 WICKER AVE | ||||||||
| Address2: | |||||||||
| City: | SAINT JOHN | ||||||||
| State: | IN | ||||||||
| PostalCode: | 463738878 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2193656554 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9200 CALUMET AVE | ||||||||
| Address2: | SUITE N-502 | ||||||||
| City: | MUNSTER | ||||||||
| State: | IN | ||||||||
| PostalCode: | 463212885 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2198534633 | ||||||||
| FaxNumber: | 2198534634 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2007 | ||||||||
| LastUpdateDate: | 07/02/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 05007804A | IN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.