MEDICARE: KIMBERLY ANNE ANDRICH PT

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	2251X0800X	Orthopedic Physical Therapist	10035-024	WI

General Provider Information

NPI Number	:	1265638878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY ANNE ANDRICH PT

Provider Business Mailing Address
First Line	:	456 CLINTON CT
Second Line	:
City	:	AMHERST
State	:	WI
Zip	:	54406-9203
Country	:	US
Telephone Number	:	715-824-7692
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 NORTHPOINTE CIR STE 302
Second Line	:
City	:	SEVEN FIELDS
State	:	PA
Zip	:	16046-7861
Country	:	US
Telephone Number	:	800-815-8577
Fax Number	:

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

Provider Enumeration Date	:	06/21/2007
Last Update Date	:	01/24/2013

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