Doctor Name: | JEREMY ANDERSON |
NPI Number: | 1427442342 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 05011672A |
Business Practice Address: | 1010 W Washington Center Rd Fort Wayne, IN - 468254155 |
Business Phone Number: | 2604892552 |
Business Fax Number: | |
Mailing Address: | 1010 W Washington Center Rd, FORT WAYNE |
State: | IN |
Postal Code: | 468254155 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/28/2015 |
NPI Last Update Date: | 03/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 05011672A |
Healthcare Provider Taxonomy: (Secondary) | Y |
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 |