Larry Andrews

Individual provider Active NPI Pediatric Physical Therapist · Powder Springs, GA

NPI 1376707182 · NPPES record last updated Jul 11, 2008

Key facts

NPI
1376707182
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Physical Therapist 2251P0200X
License
PT000462 (GA)
Practice address
534 Owl Creek Dr
Powder Springs, GA 30127-6285
Phone
(770) 361-4124
NPI assigned
Jul 11, 2008
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

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

State licenses

LicenseStateTypeSpecialty
PT000462GAMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Rehabilitation and Consulting Past Accepting new patients
Mobility Physical Therapy Pediatrics Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X PT000462 GA Yes

Addresses

Primary practice location

534 Owl Creek Dr
Powder Springs, GA 30127-6285

Mailing address

534 Owl Creek Dr
Powder Springs, GA 30127-6285
Phone (770) 361-4124

Other providers in Powder Springs, GA

All providers in Powder Springs, GA · Pediatric Physical Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.