Provider Demographics
NPI:1619051182
Name:WASELY, ANDREW P (PT)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:P
Last Name:WASELY
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:3585 PEACHTREE INDUSTRIAL BLVD
Mailing Address - Street 2:SUITES 140-142
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-6378
Mailing Address - Country:US
Mailing Address - Phone:770-497-1732
Mailing Address - Fax:770-497-1786
Practice Address - Street 1:3585 PEACHTREE INDUSTRIAL BLVD
Practice Address - Street 2:SUITES 140-142
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-6378
Practice Address - Country:US
Practice Address - Phone:770-497-1732
Practice Address - Fax:770-497-1786
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GAPT006065225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist