Provider Demographics
NPI:1912587965
Name:ANDRES, ANTHONY MICHAEL (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:MICHAEL
Last Name:ANDRES
Suffix:
Gender:M
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 1:43303 W COURTNEY DR
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85138-2396
Mailing Address - Country:US
Mailing Address - Phone:320-360-9108
Mailing Address - Fax:
Practice Address - Street 1:43303 W COURTNEY DR
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85138-2396
Practice Address - Country:US
Practice Address - Phone:320-360-9108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist