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General NPI Number Information
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NPI Number | 1770834210
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Entity Type | Individual
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Provider Name | ANDREW MCNALLY MPT
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Gender | Male
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Dates
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Enumeration Date | 09/24/2012
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Last Update Date | 09/24/2012
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Provider Practice Location Address
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Address Line | 3226 VETERANS STADIUM DR
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City | TROY
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State | AL
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Zip | 36082-0001
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Country | US
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Telephone | 334-670-5955
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Fax |
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Provider Business Mailing Address
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Address Line | 8530 MARSH POINTE DR
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City | MONTGOMERY
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State | AL
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Zip | 36117-7544
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | PTH6594
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License Number State | AL
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