Provider Demographics
NPI:1336357458
Name:READ, ANDREA CHAVES (PT)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:CHAVES
Last Name:READ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:753 S KNOWLES AVE
Mailing Address - Street 2:
Mailing Address - City:NEW RICHMOND
Mailing Address - State:WI
Mailing Address - Zip Code:54017-1751
Mailing Address - Country:US
Mailing Address - Phone:715-246-3809
Mailing Address - Fax:715-246-7139
Practice Address - Street 1:753 S KNOWLES AVE
Practice Address - Street 2:
Practice Address - City:NEW RICHMOND
Practice Address - State:WI
Practice Address - Zip Code:54017-1751
Practice Address - Country:US
Practice Address - Phone:715-246-3809
Practice Address - Fax:715-246-7139
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17698225100000X
WI11621-024225100000X
NY028835225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist