| NPI | 1215363932 |
|---|---|
| Former Name | AMANDA RENEE RICHARDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 43011) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 20780) |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2022-07-21 |