Provider Demographics
NPI:1912604877
Name:CASTEEL, ANDREA (COTA/L)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:CASTEEL
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 DEER RUN
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-8586
Mailing Address - Country:US
Mailing Address - Phone:770-871-6268
Mailing Address - Fax:
Practice Address - Street 1:3333 E CHEROKEE DR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-9229
Practice Address - Country:US
Practice Address - Phone:678-880-9856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOTA002367208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation