Provider Demographics
NPI:1851316939
Name:ABERCROMBIE, ANDREA LEIGH (PT)
Entity Type:Individual
Prefix:MISS
First Name:ANDREA
Middle Name:LEIGH
Last Name:ABERCROMBIE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:1941 DAYTON BLVD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-6409
Mailing Address - Country:US
Mailing Address - Phone:423-299-5461
Mailing Address - Fax:423-602-5461
Practice Address - Street 1:1941 DAYTON BLVD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37415-6409
Practice Address - Country:US
Practice Address - Phone:423-299-5461
Practice Address - Fax:423-602-5461
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT93072251X0800X
ALPTH22332251G0304X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL890016740Medicaid
AL51528400Medicare UPIN
ALQ48604Medicare ID - Type UnspecifiedMEDICARE PT PROVIDER NUMB