Individual
NICHOLAS RHYS ANDERSHOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
250 N LITCHFIELD RD STE 155, GOODYEAR, AZ 85338-1367
(623) 882-9787
Mailing address
8522 N 114TH AVE, PEORIA, AZ 85345-3450
(219) 707-6439
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
LPT-30072
AZ
225100000X
Physical Therapist
PT026436
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497264287
—
PA
Enumeration date
09/25/2017
Last updated
12/08/2020
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