Individual
AMANDA JEAN WAKEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
540 E YOUNG AVE, STE E, WARRENSBURG, MO 64093-1231
(660) 262-4795
(660) 747-0347
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2016027664
MO
Other
Enumeration date
08/19/2016
Last updated
08/19/2016
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