Provider Demographics
NPI:1164656682
Name:STAMP, ANDREW LEFEBVRE (DPT)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:LEFEBVRE
Last Name:STAMP
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 213
Mailing Address - Street 2:
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96767-0213
Mailing Address - Country:US
Mailing Address - Phone:808-463-9774
Mailing Address - Fax:
Practice Address - Street 1:1010 FRONT ST
Practice Address - Street 2:A205
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-1673
Practice Address - Country:US
Practice Address - Phone:808-463-9774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2957225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist