Provider Demographics
NPI:1912153024
Name:DUTCHOVER, HENRY STEVE JR (PT)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:STEVE
Last Name:DUTCHOVER
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:MR
Other - First Name:HANK
Other - Middle Name:STEVE
Other - Last Name:DUTCHOVER
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:PT,
Mailing Address - Street 1:5226 WALES DR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-7520
Mailing Address - Country:US
Mailing Address - Phone:541-510-2521
Mailing Address - Fax:
Practice Address - Street 1:425 ALEXANDER LOOP
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6524
Practice Address - Country:US
Practice Address - Phone:541-345-6199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4364225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist