Provider Demographics
NPI:1972814119
Name:RIZZIE, ANDREA K (DPT)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:K
Last Name:RIZZIE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:ANDREA
Other - Middle Name:K
Other - Last Name:GUZIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 601791
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-1791
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10315 HAMPTONS PARK DR
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-7217
Practice Address - Country:US
Practice Address - Phone:704-323-2809
Practice Address - Fax:704-323-3991
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT020545225100000X
NCP12564225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0397730014OtherNSC#