Healthcare Provider Details

I. General information

NPI: 1720137698
Provider Name (Legal Business Name): RAYMOND ANDY SPEELMAN CP BOCP COF
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

638 ROSTRAVER RD SUITE 102
BELLE VERNON PA
15012-1967
US

IV. Provider business mailing address

638 ROSTRAVER RD SUITE 102
BELLE VERNON PA
15012-1967
US

V. Phone/Fax

Practice location:
  • Phone: 724-350-0458
  • Fax: 724-930-8545
Mailing address:
  • Phone: 724-350-0458
  • Fax: 724-930-8545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224P00000X
TaxonomyProsthetist
License NumberABC CP003203
License Number State
# 2
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License NumberBOC C16482
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: