Provider Demographics
NPI:1235782889
Name:DELOZIER, ERIC
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:DELOZIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5308 S BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-8732
Mailing Address - Country:US
Mailing Address - Phone:540-809-7692
Mailing Address - Fax:
Practice Address - Street 1:5308 S BRANCH RD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-8732
Practice Address - Country:US
Practice Address - Phone:540-809-7692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer