Individual
MS. AMANDA NICOLE LARUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5901 BROKEN SOUND PKWY STE 500, BOCA RATON, FL 33487-2791
(800) 875-8999
Mailing address
1055 25TH ST NE, HICKORY, NC 28601-3029
(828) 320-6827
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2070555
TX
225200000X
Physical Therapy Assistant
Primary
3719
NC
Other
Enumeration date
08/10/2009
Last updated
08/10/2009
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