Provider Demographics
NPI:1407504715
Name:FLAHERTY, ANDREW (DPT)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:FLAHERTY
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 1:28665 HICKORY LODGE DR
Mailing Address - Street 2:
Mailing Address - City:VAN METER
Mailing Address - State:IA
Mailing Address - Zip Code:50261-6030
Mailing Address - Country:US
Mailing Address - Phone:515-975-1357
Mailing Address - Fax:
Practice Address - Street 1:2707 171ST PL NE STE 101
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98271-4740
Practice Address - Country:US
Practice Address - Phone:360-386-7401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-15
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist