Provider Demographics
NPI:1366995979
Name:ESHERICK, BRYAN (PT, DPT)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:
Last Name:ESHERICK
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1429 RUGBY AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-5135
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5690 THREE NOTCH D RD
Practice Address - Street 2:SUITE 107
Practice Address - City:CROZET
Practice Address - State:VA
Practice Address - Zip Code:22932-3172
Practice Address - Country:US
Practice Address - Phone:434-823-7628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-31
Last Update Date:2016-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23052104942251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic