Provider Demographics
NPI:1952067464
Name:POHL, ERIC WITHAM (PT)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:WITHAM
Last Name:POHL
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:150 OSIGIAN BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-8978
Mailing Address - Country:US
Mailing Address - Phone:478-333-3075
Mailing Address - Fax:478-333-3484
Practice Address - Street 1:6040 LAKESIDE COMMONS DR STE A
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-5794
Practice Address - Country:US
Practice Address - Phone:478-254-6880
Practice Address - Fax:478-254-6883
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-10
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAPT007093225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist