| NPI | 1891272209 |
|---|---|
| Former Name | AMANDA ALLEN INGERSOLL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 045822) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 27209) |
| 225100000X Physical Therapist (Licence: VA 2305209456) | |
| Enumeration Date | 2018-07-27 |
| Last Update Date | 2020-08-20 |