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NPI Code Detail

MEDICARE: ANDREA DEAN PT, DPT

MEDICARE: ANDREA DEAN PT, DPT
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 Therapist070.025993IL
2225100000XPhysical Therapist30095MD

General Provider Information

NPI Number : 1457924177
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA DEAN PT, DPT
Provider Business Mailing Address
First Line : 4960 PINE KNOB LN
Second Line :
City : CLARKSTON
State : MI
Zip : 48346-4059
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1836 GREENE TREE RD
Second Line :
City : PIKESVILLE
State : MD
Zip : 21208-1381
Country : US
Telephone Number : 410-486-9992
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2021
Last Update Date : 09/11/2024

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