| NPI | 1700649142 |
|---|---|
| Former Name | AMANDA STANISLOVAITIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT61503221) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT018625) |
| Enumeration Date | 2024-01-30 |
| Last Update Date | 2025-09-11 |