Provider Demographics
NPI:1043416217
Name:ANTONE, ANDREA WARD (PT)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:WARD
Last Name:ANTONE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7960 STEWARTS FERRY PIKE
Mailing Address - Street 2:
Mailing Address - City:MT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-7101
Mailing Address - Country:US
Mailing Address - Phone:615-453-3593
Mailing Address - Fax:
Practice Address - Street 1:1215 21ST AVE S STE 3312
Practice Address - Street 2:3200 MEDICAL CENTER EAST, SOUTH TOWER
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0014
Practice Address - Country:US
Practice Address - Phone:615-835-1084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5233225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist