Provider Demographics
NPI:1437377868
Name:ANDREWS, ANTHONY WADE (MA ,ATC, CPED)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:WADE
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:MA ,ATC, CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 JAMESTOWN MANOR PARK
Mailing Address - Street 2:
Mailing Address - City:GARDENDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35071
Mailing Address - Country:US
Mailing Address - Phone:205-631-6434
Mailing Address - Fax:
Practice Address - Street 1:1600 7TH AVENUE SOUTH
Practice Address - Street 2:
Practice Address - City:BIRMINGHM
Practice Address - State:AL
Practice Address - Zip Code:35233
Practice Address - Country:US
Practice Address - Phone:205-934-1041
Practice Address - Fax:205-975-6109
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5672255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer