Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | 6265 | AZ |
Y | 2251X0800X | Physical Therapist - Orthopedic | 6265 | AZ |
NPI | 1306997580 |
---|---|
Provider Name | Dr. Keith James Pritchette |
First Address | Phoenix, AZ 85044-3320 |
Second Address | Phoenix, AZ 85044-3320 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2007 |
Last Update Date | 29/09/2017 |