Healthcare Provider Details

I. General information

NPI: 1972060937
Provider Name (Legal Business Name): TRITTSCHUH PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2019
Last Update Date: 11/10/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 W 1ST AVE
PIERSON FL
32180-2200
US

IV. Provider business mailing address

163 W 1ST AVE
PIERSON FL
32180-2200
US

V. Phone/Fax

Practice location:
  • Phone: 386-749-0612
  • Fax: 386-749-0433
Mailing address:
  • Phone: 386-749-0612
  • Fax: 386-749-0433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name: DR. NICHOLAS JAMES LAMBERT
Title or Position: CEO
Credential: PT
Phone: 386-749-0612