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Individual

AMANDA ROSCOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
2783 SW 87TH DR STE 102, GAINESVILLE, FL 32608-9375
(352) 505-6665
(352) 226-8744
Mailing address
2783 SW 87TH DR STE 102, GAINESVILLE, FL 32608-9375
(352) 505-6665
(352) 226-8744

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 19139
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
Y003T
BCBS
FL
Enumeration date
05/08/2007
Last updated
07/01/2013
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