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General NPI Number Information
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NPI Number | 1225642358
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Entity Type | Individual
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Provider Name | ANDREW DEITER DPT
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Gender | Male
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Dates
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Enumeration Date | 09/05/2020
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 5849 W SAGINAW HWY
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City | LANSING
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State | MI
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Zip | 48917-2460
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Country | US
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Telephone | 517-827-8644
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 BUTTERFIELD RD STE 1600
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1211
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Country | US
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Telephone |
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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 | 101487
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501304032
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License Number State | MI
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