Individual
AMANDA NICHOLE BIRDSALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4200 LIVE OAK ST, DALLAS, TX 75204-6733
(214) 515-6131
Mailing address
5208 FORT BUCKNER DR, MCKINNEY, TX 75070-7043
(469) 463-6184
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2127683
TX
Other
Enumeration date
09/10/2018
Last updated
09/10/2018
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