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General NPI Number Information
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NPI Number | 1205715844
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Entity Type | Individual
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Provider Name | ERIC J PACHECO
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Gender |
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Dates
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Enumeration Date | 08/28/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 1731 W RIDGEWAY AVE STE 600
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City | WATERLOO
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State | IA
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Zip | 50701-4594
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Country | US
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Telephone | 319-833-5961
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Fax | 319-833-5969
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Provider Business Mailing Address
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Address Line | 609 1ST AVE NE
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City | WAVERLY
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State | IA
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Zip | 50677-1716
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Country | US
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Telephone | 308-440-4936
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | IA
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