| NPI | 1730189457 |
|---|---|
| Former Name | AMANDA DYAN DEPRIEST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MO 2002003114) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: KS 14-01647) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2008-11-26 |