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General NPI Number Information
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NPI Number | 1932899978
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Entity Type | Individual
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Provider Name | ANDREW EVERETT PEREZ PT, DPT, CSCS
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Gender | Male
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Dates
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Enumeration Date | 05/12/2023
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 27TH SPECIAL OPERATIONS MEDICAL GROUP 224 W D. L. INGRAM AVE, BLDG 1408, CANNON AFB
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City | CLOVIS
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State | NM
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Zip | 88103
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Country | US
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Telephone | 575-784-4425
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Fax |
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Provider Business Mailing Address
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Address Line | 27TH SPECIAL OPERATIONS MEDICAL GROUP 224 W D. L. INGRAM AVE, BLDG 1408, CANNON AFB
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City | CLOVIS
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State | NM
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Zip | 88103
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT40267
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License Number State | FL
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