Provider Demographics
NPI:1942595996
Name:JON J EHRICH LLC
Entity Type:Organization
Organization Name:JON J EHRICH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:J
Authorized Official - Last Name:EHRICH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-656-2666
Mailing Address - Street 1:2401 PGA BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3590
Mailing Address - Country:US
Mailing Address - Phone:561-656-2666
Mailing Address - Fax:561-626-7593
Practice Address - Street 1:2401 PGA BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3590
Practice Address - Country:US
Practice Address - Phone:561-656-2666
Practice Address - Fax:561-626-7593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS6711208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty