Doctor Name: | LUCAS RYAN PETKEWITZ |
NPI Number: | 1003228057 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | PT014800 |
Business Practice Address: | 8073 Washington Village Dr Suite 110 Dayton, OH - 454581847 |
Business Phone Number: | 9379388380 |
Business Fax Number: | 9379388392 |
Mailing Address: | 8073 Washington Village Dr, Suite 110 DAYTON |
State: | OH |
Postal Code: | 454581847 |
Phone Number: | 9379388380 |
Fax Number: | 9379388392 |
NPI Enumeration Date: | 05/27/2014 |
NPI Last Update Date: | 05/27/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT014800 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |