Provider Demographics
NPI:1093507097
Name:WHITEHEAD, ANDREW (DPT)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:WHITEHEAD
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 GRANDVIEW PKWY APT 536
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-1983
Mailing Address - Country:US
Mailing Address - Phone:205-876-5248
Mailing Address - Fax:
Practice Address - Street 1:169 OXMOOR RD STE 101
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-5969
Practice Address - Country:US
Practice Address - Phone:205-291-8512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH12267225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist