Healthcare Provider Details

I. General information

NPI: 1194286070
Provider Name (Legal Business Name): ANDREW JUNAK PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 LEIST STREET
AMANDA OH
43102
US

IV. Provider business mailing address

471 CHERRY HILL CT
LITHOPOLIS OH
43136-9714
US

V. Phone/Fax

Practice location:
  • Phone: 614-467-0285
  • Fax:
Mailing address:
  • Phone: 216-402-9294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT016405
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: