| Doctor Name: | ANDREW HAVERSTOCK |
| NPI Number: | 1407074693 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 05007676A |
| Business Practice Address: | 344 S Walnut Ridge Ct Frankfort, IL - 604232129 |
| Business Phone Number: | 2192290322 |
| Business Fax Number: | 7084792111 |
| Mailing Address: | 344 S Walnut Ridge Ct, FRANKFORT |
| State: | IL |
| Postal Code: | 604232129 |
| Phone Number: | 2192290322 |
| Fax Number: | 7084792111 |
| NPI Enumeration Date: | 04/23/2007 |
| NPI Last Update Date: | 10/15/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 05007676A |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| 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 |