Individual
MR. ERIC INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
1003 RIVER ST, C, SANTA CRUZ, CA 95060-1754
(831) 457-1800
(831) 457-1802
Mailing address
PO BOX 3751, SANTA CRUZ, CA 95063-3751
(831) 457-1800
(831) 457-1802
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
008448
GA
2251X0800X
Orthopedic Physical Therapist
Primary
25727
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP477Z
PTAN
CA
Enumeration date
06/30/2006
Last updated
02/09/2009
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