MEDICARE: ANDREW FARMER 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	225100000X	Physical Therapist	P13481	NC
2	225100000X	Physical Therapist	PT010541	GA

General Provider Information

NPI Number	:	1275810269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW FARMER PT

Provider Business Mailing Address
First Line	:	2700 BRASELTON HWY
Second Line	:	STE 10-132
City	:	DACULA
State	:	GA
Zip	:	30019-3262
Country	:	US
Telephone Number	:	678-439-8320
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 BRASELTON HWY
Second Line	:	STE 10-132
City	:	DACULA
State	:	GA
Zip	:	30019-3262
Country	:	US
Telephone Number	:	678-439-8320
Fax Number	:

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

Provider Enumeration Date	:	11/04/2011
Last Update Date	:	02/07/2012

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Directions to “ ANDREW FARMER PT” Practice Location

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