| NPI | 1336928852 |
|---|---|
| Former Name | AMANDA LAINE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: FL PT40752) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT40752) |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2024-11-04 |