Provider Demographics
NPI:1811940687
Name:ESTEY, ANDREW B (MSPT)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:B
Last Name:ESTEY
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2403 S 133RD PLZ
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-5905
Mailing Address - Country:US
Mailing Address - Phone:402-330-8433
Mailing Address - Fax:402-330-8616
Practice Address - Street 1:309 N ANKENY BLVD
Practice Address - Street 2:STE B
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-1750
Practice Address - Country:US
Practice Address - Phone:515-964-2559
Practice Address - Fax:515-964-2593
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03905225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist