Healthcare Provider Details

I. General information

NPI: 1053914713
Provider Name (Legal Business Name): ANDREW BICK DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2020
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5002 S MILL AVE
TEMPE AZ
85282-6828
US

IV. Provider business mailing address

5002 S MILL AVE
TEMPE AZ
85282-6828
US

V. Phone/Fax

Practice location:
  • Phone: 602-512-8607
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP025024T
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2019027819
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: