MEDICARE: HALI ANDERSON 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	17166	MD

General Provider Information

NPI Number	:	1710040985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALI ANDERSON PT

Provider Business Mailing Address
First Line	:	511 JERMOR LANE
Second Line	:	SUITE B
City	:	WESTMINSTER
State	:	MD
Zip	:	21157
Country	:	US
Telephone Number	:	410-876-8076
Fax Number	:	410-876-3818

Provider Business Practice Location Address
First Line	:	431 E RIDGEVILLE BLVD
Second Line	:
City	:	MT AIRY
State	:	MD
Zip	:	21771
Country	:	US
Telephone Number	:	301-829-6811
Fax Number	:	301-829-6623

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

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	10/07/2008

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Directions to “ HALI ANDERSON PT” Practice Location

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