Individual
MRS. AMANDA N PETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
204 S IH 35, STE 203, GEORGETOWN, TX 78628-4126
(512) 863-7761
(512) 863-0973
Mailing address
204 S IH 35, STE 203, GEORGETOWN, TX 78628-4126
(512) 863-7761
(512) 863-0973
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1134153
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2274981
FIRST HEALTH
TX
01
—
7268629
AETNA HEALTHCARE
TX
Enumeration date
08/16/2006
Last updated
07/08/2007
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