Individual
AMANDA M MINICK
Active
Individual
AMANDA M MINICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10010
TN
225100000X
Physical Therapist
10335
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079Y3
BCBS
NC
01
—
188109
MEDCOST
NC
05
—
7211956
—
NC
05
—
Q033316
—
TN
Enumeration date
08/01/2006
Last updated
01/25/2024
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