Provider Demographics
NPI:1679995872
Name:ANDRE AND ASSOCIATES PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:ANDRE AND ASSOCIATES PHYSICAL THERAPY, INC.
Other - Org Name:THE PRACTICE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY/PRESIDEN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRE
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:800-245-5851
Mailing Address - Street 1:7280 HILLSIDE AVE
Mailing Address - Street 2:#201
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046-2375
Mailing Address - Country:US
Mailing Address - Phone:800-245-5851
Mailing Address - Fax:
Practice Address - Street 1:7280 HILLSIDE AVE
Practice Address - Street 2:#201
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046-2375
Practice Address - Country:US
Practice Address - Phone:800-245-5851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-08
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty