Healthcare Provider Details

I. General information

NPI: 1518536655
Provider Name (Legal Business Name): ANDREA MARKIN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2021
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 W STATE ST
BOTKINS OH
45306-8029
US

IV. Provider business mailing address

103 S MILL ST APT A
BOTKINS OH
45306
US

V. Phone/Fax

Practice location:
  • Phone: 937-691-2004
  • Fax:
Mailing address:
  • Phone: 937-605-3263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86434114
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number019397
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: