| NPI | 1093184020 |
|---|---|
| Former Name | AMANDA BROYLES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2011017878) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2015-09-21 |
| Last Update Date | 2022-07-21 |