Individual
ANDREW J FECTEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1441SWCHANDLER AVE 104, BEND, OR 97702-3208
(541) 280-4170
Mailing address
912NWRIVERSIDE BLVD, BEND, OR 97703-2732
(541) 280-4170
(541) 610-1838
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2914
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203430
—
OR
Enumeration date
01/28/2011
Last updated
10/23/2015
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