Provider Demographics
NPI:1043770811
Name:ANDREWS, ELIZABETH (PTA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10007 WALSHAM CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23238-5423
Mailing Address - Country:US
Mailing Address - Phone:804-380-6616
Mailing Address - Fax:
Practice Address - Street 1:10007 WALSHAM CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23238-5423
Practice Address - Country:US
Practice Address - Phone:804-380-6616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-20
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306604032208100000X
MDCP026096A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation