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Individual

JACK GERLITZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
14302 WINTERVIEW PKWY, MIDLOTHIAN, VA 23113
(804) 601-6010
Mailing address
1311 MAMARONECK AVE STE 140, WHITE PLAINS, NY 10605-5224

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1347233
TX
225100000X
Physical Therapist
Primary
2305215270
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1347233
STATE LICENSE
TX
Enumeration date
07/23/2021
Last updated
07/10/2023
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