Provider Demographics
NPI:1295289155
Name:PILCH, NICHOLAS
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:PILCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 KATLIAN ST
Mailing Address - Street 2:STE E
Mailing Address - City:SITKA
Mailing Address - State:AK
Mailing Address - Zip Code:99835-7359
Mailing Address - Country:US
Mailing Address - Phone:907-747-4559
Mailing Address - Fax:907-747-5415
Practice Address - Street 1:700 KATLIAN ST
Practice Address - Street 2:STE E
Practice Address - City:SITKA
Practice Address - State:AK
Practice Address - Zip Code:99835-7359
Practice Address - Country:US
Practice Address - Phone:907-747-4559
Practice Address - Fax:907-747-5415
Is Sole Proprietor?:No
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist