Provider Demographics
NPI:1487610176
Name:PYATT, JOHN MARCUS (PT)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:MARCUS
Last Name:PYATT
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 1:4373 WORTH DR W
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-7501
Mailing Address - Country:US
Mailing Address - Phone:904-739-8280
Mailing Address - Fax:
Practice Address - Street 1:4101-1 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205-5318
Practice Address - Country:US
Practice Address - Phone:904-387-0370
Practice Address - Fax:904-387-0156
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT167542251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics