Individual
AMANDA ELLEN CROUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
136 FLAT FORK RD, WARTBURG, TN 37887-3200
(423) 622-1551
(877) 856-7133
Mailing address
PO BOX 8114, CHATTANOOGA, TN 37414-0114
(423) 622-1551
(877) 856-7133
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7311
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7311
HEALTH LICENSE
TN
Enumeration date
05/28/2019
Last updated
05/28/2019
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