Provider Demographics
NPI:1912205493
Name:GESSERT, ANDREW STEPHEN (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:STEPHEN
Last Name:GESSERT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 W EISENHOWER CIR STE 106
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-6400
Mailing Address - Country:US
Mailing Address - Phone:734-221-0362
Mailing Address - Fax:
Practice Address - Street 1:905 W EISENHOWER CIR STE 106
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-6400
Practice Address - Country:US
Practice Address - Phone:734-221-0362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-07
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11714111N00000X
MI2301010046111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor