| Doctor Name: | MR. ANDREW T JACQUAY |
| NPI Number: | 1669728499 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPT |
| License Number: | 27316 |
| Business Practice Address: | 31 Lupi Ct Suite 150 Palm Coast, FL - 321374761 |
| Business Phone Number: | 3864470011 |
| Business Fax Number: | |
| Mailing Address: | 13401 Sutton Park Dr S, Apt #714 JACKSONVILLE |
| State: | FL |
| Postal Code: | 322245266 |
| Phone Number: | 8592505061 |
| Fax Number: | |
| NPI Enumeration Date: | 07/30/2012 |
| NPI Last Update Date: | 12/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 27316 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| 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 |