Provider Demographics
NPI:1932881158
Name:EAKIN, ANDREW KEITH (DPT)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:KEITH
Last Name:EAKIN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 DEER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SULPHUR
Mailing Address - State:LA
Mailing Address - Zip Code:70665-9300
Mailing Address - Country:US
Mailing Address - Phone:337-287-2892
Mailing Address - Fax:
Practice Address - Street 1:190 GLORIA DR UNIT 100
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70611-5043
Practice Address - Country:US
Practice Address - Phone:337-214-2930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11619225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist