Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 11-02672 | KS |
N | 2251G0304X | Physical Therapist - Geriatrics | 110295 | MO |
NPI | 1215418553 |
---|---|
Provider Name | Amy Andrews |
First Address | Parkville, MO 64152-3172 |
Second Address | Atchison, KS 66002-2724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2018 |
Last Update Date | 08/04/2021 |