MEDICARE: ANDREA LEVKOWITZ P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	8203	AZ

General Provider Information

NPI Number	:	1225434806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA LEVKOWITZ P.T.

Provider Business Mailing Address
First Line	:	PO BOX 12127
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-4012
Country	:	US
Telephone Number	:	480-834-5111
Fax Number	:	480-834-5222

Provider Business Practice Location Address
First Line	:	4344 E PRESIDIO ST
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85215-1134
Country	:	US
Telephone Number	:	480-834-5111
Fax Number	:	480-834-5222

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2014
Last Update Date	:	08/12/2015

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