Provider Demographics
NPI:1063259521
Name:WOJAK-PIOTROW, MARTINA
Entity type:Individual
Prefix:
First Name:MARTINA
Middle Name:
Last Name:WOJAK-PIOTROW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 240527
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99524-0527
Mailing Address - Country:US
Mailing Address - Phone:907-561-4421
Mailing Address - Fax:907-561-5257
Practice Address - Street 1:4141 B ST STE 407
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-5944
Practice Address - Country:US
Practice Address - Phone:907-561-4421
Practice Address - Fax:907-561-5257
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK221864225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty