Provider Demographics
NPI:1679978506
Name:MEASOR, ANDREA (PT)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:
Last Name:MEASOR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 LIVE SPRINGS WAY
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6367
Mailing Address - Country:US
Mailing Address - Phone:229-938-2198
Mailing Address - Fax:
Practice Address - Street 1:5610 HAMPTON PARK DR
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-4004
Practice Address - Country:US
Practice Address - Phone:678-208-2788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT 7499225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist