Provider Demographics
NPI:1235756396
Name:FINCH, ERIC M (PTA,CLT)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:M
Last Name:FINCH
Suffix:
Gender:M
Credentials:PTA,CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8599 A C SKINNER PKWY UNIT 1215
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-0854
Mailing Address - Country:US
Mailing Address - Phone:540-850-5789
Mailing Address - Fax:
Practice Address - Street 1:3 NORTH PAVILION PLACE
Practice Address - Street 2:
Practice Address - City:PENNY FARMS
Practice Address - State:FL
Practice Address - Zip Code:32079
Practice Address - Country:US
Practice Address - Phone:904-284-5994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA27131225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant