Provider Demographics
NPI:1821000589
Name:LACHUT, PATRICK GEORGE (MPT)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:GEORGE
Last Name:LACHUT
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51SOCKANOSSET CROSS RD
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-5558
Mailing Address - Country:US
Mailing Address - Phone:401-944-7574
Mailing Address - Fax:401-944-7602
Practice Address - Street 1:51 SOCKANOSSET CROSS RD
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-5536
Practice Address - Country:US
Practice Address - Phone:401-944-7574
Practice Address - Fax:401-944-7602
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPTO1574225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIPT01574OtherPT NUMBER
RIPT01574OtherPT NUMBER