Provider Demographics
NPI:1336611300
Name:VALENTI, ANDREW (PTA)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:VALENTI
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:ANDY
Other - Middle Name:
Other - Last Name:VALENTI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PTA
Mailing Address - Street 1:245 ASH ST
Mailing Address - Street 2:
Mailing Address - City:DWIGHT
Mailing Address - State:NE
Mailing Address - Zip Code:68635-3078
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:245 ASH ST
Practice Address - Street 2:
Practice Address - City:DWIGHT
Practice Address - State:NE
Practice Address - Zip Code:68635-3078
Practice Address - Country:US
Practice Address - Phone:402-367-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-01
Last Update Date:2019-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1281225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant