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Individual

AMANDA R TATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
2405 ATHERHOLT RD, LYNCHBURG, VA 24501-2184
(434) 485-8500
(434) 485-8599
Mailing address
2405 ATHERHOLT RD, LYNCHBURG, VA 24501-2184
(434) 485-8500
(434) 485-8599

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
2305206703
VA
2251X0800X
Orthopedic Physical Therapist
6255
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3645869
TN
Enumeration date
07/25/2006
Last updated
01/05/2011
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