Jagodzinski, Mark Andrew
Jagodzinski, Mark Andrew is an sole proprietor health care provider with primary practice located at 12515 W Bell Rd Ste 103 , Surprise AZ 85378-9701. He recently has 6 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Geriatrics, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic is his primary health care specialty. Jagodzinski, Mark Andrew can be contacted via phone (623) 234-4171.Contact Information
Primary practice address
12515 W Bell Rd Ste 103
Surprise AZ 85378-9701
Phone: (623) 234-4171
Fax: (623) 234-4173
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 5576 | Arizona |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Geriatrics | 2251G0304X | 5576 | Arizona |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand | 2251H1200X | 5576 | Arizona |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 2251P0200X | 5576 | Arizona |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports | 2251S0007X | 5576 | Arizona |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic | 2251X0800X | 5576 | Arizona |
Profile Details
| NPI number | 1891732467 |
|---|---|
| LBN Legal business name | Jagodzinski, Mark Andrew |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 1st, 2006 |
| Last updated | Jan 17th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891732467 | NPPES |
| Arizona | MEDICAID | 738792 |
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