| NPI | 1679818017 |
|---|---|
| Former Name | AMANDA ELIZABETH TAYLOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT 60498945) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT39701) |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2015-12-18 |