Provider Demographics
NPI:1558453365
Name:LAURITS, ANDY (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:ANDY
Middle Name:
Last Name:LAURITS
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 CRANBERRY ST
Mailing Address - Street 2:
Mailing Address - City:WELLS
Mailing Address - State:ME
Mailing Address - Zip Code:04090-3739
Mailing Address - Country:US
Mailing Address - Phone:207-646-8702
Mailing Address - Fax:781-246-1098
Practice Address - Street 1:384 LOWELL ST
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-1986
Practice Address - Country:US
Practice Address - Phone:781-246-2266
Practice Address - Fax:781-246-1098
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2981225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist