Provider Demographics
NPI:1386696243
Name:WINT, ERIC H (MPT, OCS)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:H
Last Name:WINT
Suffix:
Gender:M
Credentials:MPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3810 ZARING MILL CIR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-3052
Mailing Address - Country:US
Mailing Address - Phone:502-896-6686
Mailing Address - Fax:502-897-1829
Practice Address - Street 1:5919 TIMBER RIDGE DR
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-8132
Practice Address - Country:US
Practice Address - Phone:502-896-6686
Practice Address - Fax:502-897-1829
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPT004230225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY5027307Medicare ID - Type UnspecifiedMEDICARE #