Provider Demographics
NPI:1649453267
Name:FETTERMAN, ANDREW JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JOSEPH
Last Name:FETTERMAN
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 1:616 LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19312-1663
Mailing Address - Country:US
Mailing Address - Phone:610-722-0240
Mailing Address - Fax:
Practice Address - Street 1:616 LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:PA
Practice Address - Zip Code:19312-1663
Practice Address - Country:US
Practice Address - Phone:610-722-0240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009859111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor