| NPI | 1942506639 |
|---|---|
| Former Name | AMANDA ROACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC PT12938) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NC PT12938) |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2022-04-12 |