Provider Demographics
NPI:1659413995
Name:GASER, ANDREW FELIX (PT)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:FELIX
Last Name:GASER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3644
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907
Mailing Address - Country:US
Mailing Address - Phone:740-393-1144
Mailing Address - Fax:740-393-1152
Practice Address - Street 1:1220 YANGER RD
Practice Address - Street 2:
Practice Address - City:MT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050
Practice Address - Country:US
Practice Address - Phone:740-393-1144
Practice Address - Fax:740-393-1152
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT008722225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2563759Medicaid
OH9348391Medicare ID - Type Unspecified