Provider Demographics
NPI:1467680066
Name:DETWILER, ANDY S (OT)
Entity Type:Individual
Prefix:
First Name:ANDY
Middle Name:S
Last Name:DETWILER
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:800 CRESCENT CENTRE DR
Mailing Address - Street 2:SUITE 600
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-7286
Mailing Address - Country:US
Mailing Address - Phone:615-373-1350
Mailing Address - Fax:615-221-9054
Practice Address - Street 1:4027 HILLSBORO PIKE
Practice Address - Street 2:STE 801
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2782
Practice Address - Country:US
Practice Address - Phone:615-385-2201
Practice Address - Fax:615-383-8590
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN2477225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist