Provider Demographics
NPI:1295904522
Name:MAY, ANDREW (PT)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:
Last Name:MAY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 558
Mailing Address - Street 2:
Mailing Address - City:DEWITT
Mailing Address - State:MI
Mailing Address - Zip Code:48820-0558
Mailing Address - Country:US
Mailing Address - Phone:517-333-8550
Mailing Address - Fax:517-333-8539
Practice Address - Street 1:701 SNOW RD
Practice Address - Street 2:SUITE A
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-4087
Practice Address - Country:US
Practice Address - Phone:517-323-0593
Practice Address - Fax:517-333-8539
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL1181535225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI236665Medicare PIN