| NPI | 1639577810 |
|---|---|
| Former Name | AMANDA JULIENNE BOYER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 25196) |
| Additional Taxonomies | 2251N0400X Physical Therapist Neurology (Licence: WV 003427) |
| 2251X0800X Physical Therapist Orthopedic (Licence: WV 003427) | |
| Enumeration Date | 2014-12-20 |
| Last Update Date | 2020-04-24 |