Healthcare Provider Details

I. General information

NPI: 1891387379
Provider Name (Legal Business Name): ANDREW L TURNER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2021
Last Update Date: 02/06/2021
Certification Date: 02/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 VILLA RD
SPRINGFIELD OH
45503-1656
US

IV. Provider business mailing address

1292 E JACKSON RD
SPRINGFIELD OH
45502-9495
US

V. Phone/Fax

Practice location:
  • Phone: 937-390-9000
  • Fax:
Mailing address:
  • Phone: 937-926-6060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number08248
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number08248
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: