Individual provider · Type 1 NPI
Andrew Haverstock
Pediatric Physical Therapist · Frankfort, IL
Practice location
344 S Walnut Ridge Ct
Frankfort, IL 60423-2129
Fax (708) 479-2111
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physical Therapist | 225100000X | 070012822 (IL) |
| Pediatric Physical Therapist Primary | 2251P0200X | 070012822 (IL) |
| Physical Therapist | 225100000X | 05007676A (IN) |
Pediatric Physical Therapist: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, genetics, biomechanics, neurological function, neuroscience, and pathology, behavioral sciences, and understanding of diseases or conditions that necessitate physical th…
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About NPI 1407074693
Andrew Haverstock's National Provider Identifier is 1407074693, issued on Apr 23, 2007. The primary taxonomy on file is Pediatric Physical Therapist (2251P0200X), and the practice location is in Frankfort, IL. The record was last updated on Oct 15, 2015.