| NPI | 1255070769 |
|---|---|
| Former Name | AMANDA LOVE MANGELO-POMP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO MSPTL.0000030) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT019408) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT9361) | |
| Enumeration Date | 2022-06-02 |
| Last Update Date | 2024-12-06 |