Provider Demographics
NPI:1679800536
Name:HELSTROM, ANDREW J
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:HELSTROM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 BENNETT DR STE 140
Mailing Address - Street 2:
Mailing Address - City:CARIBOU
Mailing Address - State:ME
Mailing Address - Zip Code:04736-2052
Mailing Address - Country:US
Mailing Address - Phone:207-498-6334
Mailing Address - Fax:207-493-3247
Practice Address - Street 1:5 NORTH ST
Practice Address - Street 2:
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-2240
Practice Address - Country:US
Practice Address - Phone:207-769-2160
Practice Address - Fax:207-769-2161
Is Sole Proprietor?:No
Enumeration Date:2009-11-12
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAT2742255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer