Provider Demographics
NPI:1407281777
Name:HETZLER, ANDREA (DPT)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:HETZLER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BROOK RD
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-3630
Mailing Address - Country:US
Mailing Address - Phone:508-812-0426
Mailing Address - Fax:
Practice Address - Street 1:11 BROOK RD
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-3630
Practice Address - Country:US
Practice Address - Phone:508-812-0426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT02634225100000X
MAPTL20719225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist