Provider Demographics
NPI:1093487696
Name:HAMBRICK, ERIKA MALTESE GANT (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:MALTESE GANT
Last Name:HAMBRICK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:MALTESE
Other - Last Name:GANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:84 CENTENNIAL LOOP
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-7909
Mailing Address - Country:US
Mailing Address - Phone:949-290-0045
Mailing Address - Fax:831-250-6767
Practice Address - Street 1:84 CENTENNIAL LOOP
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7909
Practice Address - Country:US
Practice Address - Phone:541-255-2681
Practice Address - Fax:831-250-6767
Is Sole Proprietor?:No
Enumeration Date:2021-10-01
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA299821225100000X
OR63976225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist