Individual
MRS. AMANDA MICHELLE TRAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
10456 US HIGHWAY 62, CALVERT CITY, KY 42029
(270) 339-4670
Mailing address
184 DEXTER DRIVE, GILBERTSVILLE, KY 42044
(270) 339-4670
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A02143
KY
Other
Enumeration date
08/21/2008
Last updated
08/21/2008
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