Provider Demographics
NPI:1386325793
Name:LLOYD, ANDREA (PTA)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:LLOYD
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 UMPIRE LN
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22602-6750
Mailing Address - Country:US
Mailing Address - Phone:540-303-3732
Mailing Address - Fax:
Practice Address - Street 1:480 W JUBAL EARLY DR STE 120
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6447
Practice Address - Country:US
Practice Address - Phone:540-303-3732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306603447225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant