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1649780305
THEODORE WILLIAM POLAKOWSKI
MESA, AZ
NPI
1649780305
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2017-10-09
Last Update Date
2017-10-09
Business Address
THEODORE WILLIAM POLAKOWSKI ATC
2909 E FOX ST
MESA, AZ 85213-5443
Phone number: 480-641-1798
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Mailing Address
THEODORE WILLIAM POLAKOWSKI ATC
2909 E FOX ST
MESA, AZ 85213-5443
Phone number: 480-641-1798
Copy
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