Provider Demographics
NPI:1124884374
Name:ANDRES, ABIGAIL LINDSAY (PT, DPT)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:LINDSAY
Last Name:ANDRES
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:668 STREAMWATER DR
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-7120
Mailing Address - Country:US
Mailing Address - Phone:614-648-3634
Mailing Address - Fax:
Practice Address - Street 1:668 STREAMWATER DR
Practice Address - Street 2:
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004-7120
Practice Address - Country:US
Practice Address - Phone:614-648-3634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT014074225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist