| Doctor Name: | JESSE LEE ANDERSON |
| NPI Number: | 1164710349 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPT |
| License Number: | PT021478 |
| Business Practice Address: | 525 West Chester Pike Lower Level Havertown, PA - 190834540 |
| Business Phone Number: | 6104498400 |
| Business Fax Number: | 6104496392 |
| Mailing Address: | 3809 West Chester Pike, Ste 150 NEWTOWN SQUARE |
| State: | PA |
| Postal Code: | 190730259 |
| Phone Number: | 6103595640 |
| Fax Number: | 6103591519 |
| NPI Enumeration Date: | 07/21/2011 |
| NPI Last Update Date: | 06/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT021478 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |