Provider Demographics
NPI:1619560059
Name:PRICHARD, ERIN K (DPT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:K
Last Name:PRICHARD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3821 HARTS MILL RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-9702
Mailing Address - Country:US
Mailing Address - Phone:563-593-1395
Mailing Address - Fax:
Practice Address - Street 1:404 S 1ST ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-4122
Practice Address - Country:US
Practice Address - Phone:563-243-4301
Practice Address - Fax:563-243-4302
Is Sole Proprietor?:No
Enumeration Date:2021-02-17
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2251G0304X, 2251S0007X, 2251X0800X
IA106257225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
1124007141OtherBRADLEY C HIRL NPI
IAIB2623Medicaid
1295919546OtherGROUP NPI