Provider Demographics
NPI:1487862504
Name:BRANDT, ANDERS (PT)
Entity Type:Individual
Prefix:
First Name:ANDERS
Middle Name:
Last Name:BRANDT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8801 GENERAL COUCHS CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-1915
Mailing Address - Country:US
Mailing Address - Phone:540-399-9069
Mailing Address - Fax:
Practice Address - Street 1:2800 WELLFORD ST
Practice Address - Street 2:SUITE 201
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3176
Practice Address - Country:US
Practice Address - Phone:540-361-1830
Practice Address - Fax:540-361-4968
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305203794225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist