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NPI Code Detail

MEDICARE: JONATHAN ANDRUS

MEDICARE:   JONATHAN  ANDRUS
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
1225100000XPhysical Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13577OTHERALLICENSE#

General Provider Information

NPI Number : 1265519938
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN ANDRUS
Provider Business Mailing Address
First Line : 529 SAINT CLAIR DR
Second Line :
City : NEW MARKET
State : AL
Zip : 35761-8140
Country : US
Telephone Number : 256-859-9203
Fax Number :
Provider Business Practice Location Address
First Line : 7736 HIGHWAY 20 W
Second Line : SUITE 3
City : HUNTSVILLE
State : AL
Zip : 35806-2085
Country : US
Telephone Number : 256-430-0178
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 03/11/2009

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Directions to “ JONATHAN ANDRUS ” Practice Location

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