Individual
DR. JODY CARL ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, PT
Contact information
Practice address
401 W KENNEDY BLVD, BOX 30F, TAMPA, FL 33606-1450
(813) 257-3162
(813) 258-7482
Mailing address
401 W KENNEDY BLVD, BOX 30F, TAMPA, FL 33606-1450
(813) 257-3162
(813) 258-7482
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
PT 20698
FL
2255A2300X
Athletic Trainer
AL 1654
FL
Other
Enumeration date
02/08/2006
Last updated
01/20/2014
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