Healthcare Provider Details

I. General information

NPI: 1326438573
Provider Name (Legal Business Name): ANDREW HOVEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2015
Last Update Date: 05/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 JACOLYN DR SW
CEDAR RAPIDS IA
52404-1288
US

IV. Provider business mailing address

2836 CYPRESS DR
BETTENDORF IA
52722-2910
US

V. Phone/Fax

Practice location:
  • Phone: 319-396-0222
  • Fax: 319-396-1525
Mailing address:
  • Phone: 563-370-5091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number074511
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: