Provider Demographics
NPI:1578855292
Name:GETTMAN, ANDREA L (DPT, OTR/L)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:L
Last Name:GETTMAN
Suffix:
Gender:F
Credentials:DPT, OTR/L
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:L
Other - Last Name:MESSING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT, OTR/L
Mailing Address - Street 1:2315 HIGHWAY K
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-8659
Mailing Address - Country:US
Mailing Address - Phone:636-265-1505
Mailing Address - Fax:636-266-2112
Practice Address - Street 1:951 WATERBURY FALLS DR
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-2202
Practice Address - Country:US
Practice Address - Phone:636-336-0300
Practice Address - Fax:636-336-0297
Is Sole Proprietor?:No
Enumeration Date:2011-05-13
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011003187225X00000X
MO2011007122225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO991509009Medicare PIN