Provider Demographics
NPI:1215953260
Name:PRITZL, PATRICK JOHN (PT)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:JOHN
Last Name:PRITZL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31952 DEL OBISPO ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-3124
Mailing Address - Country:US
Mailing Address - Phone:949-240-1016
Mailing Address - Fax:949-240-4450
Practice Address - Street 1:31952 DEL OBISPO ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-3124
Practice Address - Country:US
Practice Address - Phone:949-240-1016
Practice Address - Fax:949-240-4450
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 12777225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist