Provider Demographics
NPI:1801864475
Name:ANDRESS, MARK (PT)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:
Last Name:ANDRESS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:401 CRICKET AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19038-2219
Mailing Address - Country:US
Mailing Address - Phone:215-806-3415
Mailing Address - Fax:215-886-9508
Practice Address - Street 1:3400 HORIZON DR
Practice Address - Street 2:SUITE 110
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-2675
Practice Address - Country:US
Practice Address - Phone:610-277-6447
Practice Address - Fax:610-277-8244
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-007038-L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist