Individual
ANDREW HALSTEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, ATC
Contact information
Practice address
732 MAIN ST, PHILOMATH, OR 97370-9725
(541) 929-2255
Mailing address
732 MAIN ST, PHILOMATH, OR 97370-9725
(541) 929-2255
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
63290
OR
Other
Enumeration date
06/22/2019
Last updated
06/22/2019
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