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Individual
AMANDA SOMERS
Active
Individual
AMANDA SOMERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2602
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
354105600
US DEPT. OF LABOR
SC
01
—
7796338
AETNA PROVIDER NUMBER
SC
01
—
943423122
INSURANCE PROVIDER NUMBER
SC
01
—
B6153
MEDCOST PROVIDER NUMBER
SC
05
—
TH0748
—
SC
Enumeration date
07/30/2006
Last updated
07/09/2007
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