Provider Demographics
NPI:1821422973
Name:DAVID, ANDREW J (OTR/L)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:DAVID
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 ROUX 61 DRIVE SOUTH STE D
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120
Mailing Address - Country:US
Mailing Address - Phone:601-442-3240
Mailing Address - Fax:601-445-9032
Practice Address - Street 1:9 ROUX 61 DRIVE SOUTH STE D
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120
Practice Address - Country:US
Practice Address - Phone:601-442-3240
Practice Address - Fax:601-445-9032
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSOT2817225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist