Provider Demographics
NPI:1487380200
Name:ANDALON PHYSICAL THERAPY, INC
Entity type:Organization
Organization Name:ANDALON PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDALON
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:760-805-2243
Mailing Address - Street 1:681 ENCINITAS BLVD STE 308
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-3762
Mailing Address - Country:US
Mailing Address - Phone:760-503-4440
Mailing Address - Fax:760-208-4403
Practice Address - Street 1:681 ENCINITAS BLVD STE 308
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-3762
Practice Address - Country:US
Practice Address - Phone:760-503-4440
Practice Address - Fax:760-208-4403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty