Andrew Halstead, PT, ATC

Individual provider Active NPI Physical Therapist · Philomath, OR

NPI 1033770912 · NPPES record last updated Jun 22, 2019

Key facts

NPI
1033770912
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
63290 (OR)
Practice address
732 Main St
Philomath, OR 97370-9725
Phone
(541) 929-2255
NPI assigned
Jun 22, 2019
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Therapy Services Inc Past
since Jul 30, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 63290 OR Yes

Addresses

Primary practice location

732 Main St
Philomath, OR 97370-9725

Mailing address

732 Main St
Philomath, OR 97370-9725
Phone (541) 929-2255

Other providers in Philomath, OR

All providers in Philomath, OR · Physical Therapist in Oregon

Sources for this page

Verify at the official NPI Registry.