Individual
MRS. AMANDA GAYLE CHILTON
Active
Individual
MRS. AMANDA GAYLE CHILTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2419
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5501011148
STATE OF MICHIGAN PHYSICAL THERAPIST LICENSE
MI
01
—
PT 2419
STATE OF ARKANSAS PHYSICAL THERAPIST LICENSE
AR
Enumeration date
06/02/2009
Last updated
03/14/2023
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