Individual
FORDYCE W ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
13760 N 93RD AVE, STE 107, PEORIA, AZ 85381-4201
(623) 876-3952
(623) 876-3975
Mailing address
13640 N PLAZA DEL RIO BLVD, PEORIA, AZ 85381-4846
(623) 876-3800
(623) 876-3975
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5386
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
931726
—
AZ
Enumeration date
06/07/2006
Last updated
01/23/2008
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