Provider Demographics
NPI:1023114840
Name:ANDERS, MICHAEL ALLEN (DPT)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALLEN
Last Name:ANDERS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
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Mailing Address - Street 1:718 OLD LIVERPOOL RD
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-6035
Mailing Address - Country:US
Mailing Address - Phone:315-457-7005
Mailing Address - Fax:315-457-7214
Practice Address - Street 1:526 OLD LIVERPOOL RD
Practice Address - Street 2:SUITE 4
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-6238
Practice Address - Country:US
Practice Address - Phone:315-457-7005
Practice Address - Fax:315-457-7214
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY026310-12251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic