Provider Demographics
NPI:1528373453
Name:PRINGLE, PHILLIP ANTHONY (CRTT)
Entity Type:Individual
Prefix:MR
First Name:PHILLIP
Middle Name:ANTHONY
Last Name:PRINGLE
Suffix:
Gender:M
Credentials:CRTT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1637 DEERWALK DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-7972
Mailing Address - Country:US
Mailing Address - Phone:252-908-4583
Mailing Address - Fax:
Practice Address - Street 1:1637 DEERWALK DR
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-7972
Practice Address - Country:US
Practice Address - Phone:252-908-4583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-16
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA2744227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified