Provider Demographics
NPI:1427827500
Name:ZAKRZEWSKI, NATHANIEL (PT, DPT)
Entity type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:
Last Name:ZAKRZEWSKI
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 WOODLAND ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30157-9552
Mailing Address - Country:US
Mailing Address - Phone:770-895-5119
Mailing Address - Fax:
Practice Address - Street 1:2300 LIAM AVE STE 104
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-2265
Practice Address - Country:US
Practice Address - Phone:470-294-0052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPTO16950225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist