Provider Demographics
NPI:1083157903
Name:BECHTOL, ERICA (DPT)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:BECHTOL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 TUC RD STE A
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5086
Mailing Address - Country:US
Mailing Address - Phone:410-871-2494
Mailing Address - Fax:410-861-5303
Practice Address - Street 1:7 TUC RD STE A
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5086
Practice Address - Country:US
Practice Address - Phone:410-871-2494
Practice Address - Fax:410-861-5303
Is Sole Proprietor?:No
Enumeration Date:2016-11-25
Last Update Date:2016-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD245973225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1366772568Medicare NSC