MEDICARE: ANGELA DAWN ANDREWS LPTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	2306602110	VA

General Provider Information

NPI Number	:	1033428560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA DAWN ANDREWS LPTA

Provider Business Mailing Address
First Line	:	1699 YORK DR
Second Line	:
City	:	CHRISTIANSBURG
State	:	VA
Zip	:	24073-1288
Country	:	US
Telephone Number	:	540-250-7216
Fax Number	:

Provider Business Practice Location Address
First Line	:	1699 YORK DR
Second Line	:
City	:	CHRISTIANSBURG
State	:	VA
Zip	:	24073-1288
Country	:	US
Telephone Number	:	540-250-7216
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2010
Last Update Date	:	10/01/2010

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