Provider Demographics
NPI:1205993557
Name:HILLYER, ANDREW (PT)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:HILLYER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:WINNEMUCCA
Mailing Address - State:NV
Mailing Address - Zip Code:89445-3406
Mailing Address - Country:US
Mailing Address - Phone:775-623-4813
Mailing Address - Fax:775-623-0418
Practice Address - Street 1:135 W 2ND ST
Practice Address - Street 2:
Practice Address - City:WINNEMUCCA
Practice Address - State:NV
Practice Address - Zip Code:89445-3406
Practice Address - Country:US
Practice Address - Phone:775-623-4813
Practice Address - Fax:775-623-0418
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV660225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV35498Medicare ID - Type Unspecified