Individual
DAVID ODELL ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1439 ARTIMINO LN, BOYNTON BEACH, FL 33436-1111
(561) 797-7987
Mailing address
1439 ARTIMINO LN, BOYNTON BEACH, FL 33436-1111
(843) 834-4622
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
23390
FL
225100000X
Physical Therapist
4296
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1753
—
SC
Enumeration date
01/22/2007
Last updated
01/10/2013
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