Provider Demographics
NPI:1245436468
Name:GANDHI, MANDY MARIE (PT)
Entity type:Individual
Prefix:MRS
First Name:MANDY
Middle Name:MARIE
Last Name:GANDHI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4554 E INVERNESS AVE STE C1
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4639
Mailing Address - Country:US
Mailing Address - Phone:480-926-6309
Mailing Address - Fax:480-926-1365
Practice Address - Street 1:4554 E INVERNESS AVE STE C1
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4639
Practice Address - Country:US
Practice Address - Phone:480-926-6309
Practice Address - Fax:480-926-1365
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ88992251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics