Provider Demographics
NPI:1902830326
Name:MCCOLE, ANDREW C (MS, PT, OSC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:C
Last Name:MCCOLE
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Gender:M
Credentials:MS, PT, OSC
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Mailing Address - Street 1:1115 BOULDERS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4067
Mailing Address - Country:US
Mailing Address - Phone:804-560-5595
Mailing Address - Fax:804-560-9029
Practice Address - Street 1:13700 ST FRANCIS BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-3222
Practice Address - Country:US
Practice Address - Phone:804-379-9086
Practice Address - Fax:804-379-1283
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2020-09-12
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Provider Licenses
StateLicense IDTaxonomies
VA2305002961225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA192302OtherANTHEM- ST. FRANCIS
VA540885859OtherPRIVATE HEALTHCARE SYSTEM
VA540885859OtherFOCUS
VA008908397Medicaid
VA258462OtherSOUTHERN HEALTH
VA540885859OtherFIRST HEALTH/CCN
VA540885859OtherCORVEL
VA540885859OtherMULTIPLAN
VA540885859OtherC&O EMPLOYEE'S HEALTHCARE
VA540885859OtherCOMPMANAGEMENT
VA2513324OtherAETNA HMO
VA98999OtherOPTIMA HEALTH
VA540885859OtherVIRGINIA HEALTH NETWORK
VA192302OtherANTHEM- ST. FRANCIS
VA540885859OtherFOCUS
VA009997W25Medicare PIN