Provider Demographics
NPI:1134181464
Name:ALVAREZ, ANDREW MADISON (PT)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:MADISON
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:DREW
Other - Middle Name:
Other - Last Name:ALVAREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:175 S ENGLISH STATION RD
Mailing Address - Street 2:SUITE 218
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-4160
Mailing Address - Country:US
Mailing Address - Phone:502-855-5903
Mailing Address - Fax:812-759-7490
Practice Address - Street 1:175 S ENGLISH STATION RD
Practice Address - Street 2:SUITE 218
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245-4160
Practice Address - Country:US
Practice Address - Phone:502-855-5903
Practice Address - Fax:812-759-7490
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY003932225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist