Basic Information
Provider Information
NPI: 1780623454
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STRICKLER
FirstName: DAVID
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: STRICKLER
OtherFirstName: DAVID
OtherMiddleName: E
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MPT, MA
OtherLastNameType: 2
Mailing Information
Address1: 504 ALBEMARLE SQ
Address2:  
City: CHARLOTTESVILLE
State: VA
PostalCode: 229017405
CountryCode: US
TelephoneNumber: 4348177848
FaxNumber: 4349512194
Practice Location
Address1: 504 ALBEMARLE SQ
Address2:  
City: CHARLOTTESVILLE
State: VA
PostalCode: 229017405
CountryCode: US
TelephoneNumber: 4348177848
FaxNumber: 4349512194
Other Information
ProviderEnumerationDate: 06/06/2006
LastUpdateDate: 04/05/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X2305202858VAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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