| NPI | 1669696852 |
|---|---|
| Former Name | AMANDA MARLEEN PFOST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501017783) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OH PTA 06181) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-09-10 |