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General NPI Number Information
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NPI Number | 1548693484
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Entity Type | Individual
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Provider Name | ANDREW LANTZ DPT
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Gender | Male
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Dates
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Enumeration Date | 08/14/2013
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Last Update Date | 01/01/2019
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Provider Practice Location Address
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Address Line | 1849 OLD DONATION PKWY
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-3004
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Country | US
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Telephone | 757-422-8476
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Fax | 757-213-4332
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Provider Business Mailing Address
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Address Line | 1115 BOULDERS PKWY STE 200
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23225-4067
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Country | US
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Telephone | 804-560-5595
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Fax | 804-560-9029
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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 | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 2305208243
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 2305208243
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305208243
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License Number State | VA
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