Provider Demographics
NPI:1376559419
Name:BERQUIST, ERIC K (PT)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:K
Last Name:BERQUIST
Suffix:
Gender:M
Credentials:PT
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Other - First Name:
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Mailing Address - Street 1:19785 CRYSTAL ROCK DR
Mailing Address - Street 2:STE 309
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-4700
Mailing Address - Country:US
Mailing Address - Phone:240-724-6781
Mailing Address - Fax:888-607-7117
Practice Address - Street 1:19785 CRYSTAL ROCK DR
Practice Address - Street 2:STE 309
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-4700
Practice Address - Country:US
Practice Address - Phone:240-724-6781
Practice Address - Fax:888-607-7117
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2014-08-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MD18754225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist