| NPI | 1720236490 |
|---|---|
| Former Name | AMANDA LEIGH DICKERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH4985) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AL 23663) |
| Enumeration Date | 2008-09-05 |
| Last Update Date | 2023-10-27 |