Provider Demographics
NPI:1174617088
Name:KIRLANGITIS, JOHN IRA (DPT)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:IRA
Last Name:KIRLANGITIS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 THREE SPRINGS DR STE 1
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-3839
Mailing Address - Country:US
Mailing Address - Phone:304-748-2856
Mailing Address - Fax:304-748-2856
Practice Address - Street 1:243 THREE SPRINGS DR STE 1
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-3839
Practice Address - Country:US
Practice Address - Phone:304-748-2856
Practice Address - Fax:304-748-2856
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016500225100000X
OHPT010424225100000X
WV002305225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810001308Medicaid
OH2641798Medicaid
WV3810001308Medicaid