Provider Demographics
NPI:1295074839
Name:NARDELL, ANDREW FRANCIS (PT)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:FRANCIS
Last Name:NARDELL
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 1:126 BELLEVUE AVE
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-3321
Mailing Address - Country:US
Mailing Address - Phone:802-353-3533
Mailing Address - Fax:
Practice Address - Street 1:1 SCALE AVE STE 32
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4455
Practice Address - Country:US
Practice Address - Phone:802-855-8068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040.0003164225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist