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General NPI Number Information
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NPI Number | 1043155005
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Entity Type | Individual
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Provider Name | BRIAN ANDREATTA PT
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Gender | Male
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Dates
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Enumeration Date | 04/23/2026
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Last Update Date | 04/23/2026
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Provider Practice Location Address
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Address Line | 23500 US HIGHWAY 160
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City | WALSENBURG
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State | CO
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Zip | 81089-9524
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Country | US
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Telephone | 719-989-0019
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Fax |
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Provider Business Mailing Address
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Address Line | 23500 U.S. HIGHWAY 160
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City | PUEBLO
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State | CO
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Zip | 81004-3247
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Country | US
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Telephone | 719-989-0019
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTL.0018867
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License Number State | CO
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