Provider Demographics
NPI:1942226063
Name:LAUCHU, ANDREA JILL
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:JILL
Last Name:LAUCHU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:JILL
Other - Last Name:GLASPIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9195 LAKEVIEW CT
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-9439
Mailing Address - Country:US
Mailing Address - Phone:734-972-4245
Mailing Address - Fax:
Practice Address - Street 1:3306 MEIJER DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-3103
Practice Address - Country:US
Practice Address - Phone:419-824-3434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT019547225100000X
MI5501010011225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist