Provider Demographics
NPI:1306305354
Name:ANCEL, ANDREA L (DPT)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:L
Last Name:ANCEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:L
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:347 CREEKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-8676
Mailing Address - Country:US
Mailing Address - Phone:734-755-3458
Mailing Address - Fax:
Practice Address - Street 1:347 CREEKSIDE DR
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-8676
Practice Address - Country:US
Practice Address - Phone:231-487-0080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501017768225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist