Provider Demographics
NPI:1134940612
Name:PRITCHETT, ANTONIO D'MARLOWE
Entity type:Individual
Prefix:
First Name:ANTONIO
Middle Name:D'MARLOWE
Last Name:PRITCHETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10215 PLYMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2522
Mailing Address - Country:US
Mailing Address - Phone:216-303-1363
Mailing Address - Fax:
Practice Address - Street 1:10215 PLYMOUTH AVE
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-2522
Practice Address - Country:US
Practice Address - Phone:216-303-1363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider