Provider Demographics
NPI:1497883672
Name:MASON, ANDREW THOMAS (MPT)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:THOMAS
Last Name:MASON
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2256 VAVRINA LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68512-9579
Mailing Address - Country:US
Mailing Address - Phone:402-480-2488
Mailing Address - Fax:
Practice Address - Street 1:15TH AND U ST
Practice Address - Street 2:UNIVERSITY HEALTH CENTER
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68588-0618
Practice Address - Country:US
Practice Address - Phone:402-472-7490
Practice Address - Fax:402-472-4593
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2423225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist