Healthcare Provider Details

I. General information

NPI: 1912521378
Provider Name (Legal Business Name): ANDREW JOHN FINDLEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2020
Last Update Date: 06/02/2020
Certification Date: 06/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 W JEFFERSON BLVD
SOUTH BEND IN
46601-1994
US

IV. Provider business mailing address

29330 CHANNEL VIEW DR
ELKHART IN
46516-1233
US

V. Phone/Fax

Practice location:
  • Phone: 574-647-2509
  • Fax:
Mailing address:
  • Phone: 574-849-2509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number05013316A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: