Provider Demographics
NPI:1457681819
Name:GERRITY, RICHARD ALAN (LMT)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:ALAN
Last Name:GERRITY
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4831 VILLAGE GARDENS DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34234-4039
Mailing Address - Country:US
Mailing Address - Phone:941-685-0636
Mailing Address - Fax:941-351-0790
Practice Address - Street 1:4831 VILLAGE GARDENS DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34234-4039
Practice Address - Country:US
Practice Address - Phone:941-685-0636
Practice Address - Fax:941-351-0790
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-07
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 42381225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist