Provider Demographics
NPI:1518536655
Name:MARKIN, ANDREA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:MARKIN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1258 GARBRY RD APT 9
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-8251
Mailing Address - Country:US
Mailing Address - Phone:937-605-3263
Mailing Address - Fax:
Practice Address - Street 1:212 W STATE ST
Practice Address - Street 2:
Practice Address - City:BOTKINS
Practice Address - State:OH
Practice Address - Zip Code:45306-8029
Practice Address - Country:US
Practice Address - Phone:937-691-2004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH019397225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist