| NPI | 1508294489 |
|---|---|
| Former Name | AMANDA M JOHN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 005288) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 12491-24) |
| Enumeration Date | 2013-10-31 |
| Last Update Date | 2023-07-11 |