Provider Demographics
NPI:1336591429
Name:ANDREOTTA, ANDREW (DC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:ANDREOTTA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1994 GALLATIN PIKE N
Mailing Address - Street 2:STE. 206
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-2026
Mailing Address - Country:US
Mailing Address - Phone:615-859-6677
Mailing Address - Fax:
Practice Address - Street 1:1994 GALLATIN PIKE N
Practice Address - Street 2:STE. 206
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-2026
Practice Address - Country:US
Practice Address - Phone:615-859-6677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNNOT YET RECEIVED111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor