Provider Demographics
NPI:1245490028
Name:MIRARCHI, ERIC CHARLES (MPT, CRED MDT, CSCS)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:CHARLES
Last Name:MIRARCHI
Suffix:
Gender:M
Credentials:MPT, CRED MDT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2038 SMITH TOWNSHIP STATE RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BURGETTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15021-9701
Mailing Address - Country:US
Mailing Address - Phone:724-947-1002
Mailing Address - Fax:724-947-1007
Practice Address - Street 1:2038 SMITH TOWNSHIP STATE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:BURGETTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15021-9701
Practice Address - Country:US
Practice Address - Phone:724-947-1002
Practice Address - Fax:724-947-1007
Is Sole Proprietor?:No
Enumeration Date:2008-06-14
Last Update Date:2008-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT008497L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist