Healthcare Provider Details

I. General information

NPI: 1528047206
Provider Name (Legal Business Name): PERRY M PRITCHARD PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 LURAY DR
WINTERSVILLE OH
43953-3973
US

IV. Provider business mailing address

198 HIGHLAND PARK
BLOOMINGDALE OH
43910-7760
US

V. Phone/Fax

Practice location:
  • Phone: 740-266-3866
  • Fax: 740-266-3865
Mailing address:
  • Phone: 740-944-1575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number09148
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: