Provider Demographics
NPI:1306997580
Name:PRITCHETTE, KEITH JAMES
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:JAMES
Last Name:PRITCHETTE
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 1:4730 E WARNER RD
Mailing Address - Street 2:STE 5
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-3320
Mailing Address - Country:US
Mailing Address - Phone:480-785-5738
Mailing Address - Fax:480-785-5761
Practice Address - Street 1:4730 E WARNER RD STE 10
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-3320
Practice Address - Country:US
Practice Address - Phone:480-785-5738
Practice Address - Fax:480-785-5761
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2017-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ62652251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports