| NPI | 1720021876 |
|---|---|
| Former Name | AMANDA GALLAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT017552) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA DAPT001605) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2019-03-04 |