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General NPI Number Information
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NPI Number | 1114649654
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Entity Type | Individual
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Provider Name | MARIE ANNE ANDREN PT
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Gender | Female
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Dates
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Enumeration Date | 09/12/2022
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 2001 HEATH ST
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City | WATERLOO
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State | IA
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Zip | 50703-1214
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Country | US
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Telephone | 319-234-4423
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Fax |
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Provider Business Mailing Address
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Address Line | 2240 EASLEY ST
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City | WATERLOO
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State | IA
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Zip | 50702-4110
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Country | US
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Telephone | 319-429-5876
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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 | 005360
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License Number State | IA
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