Individual
MISS AMANDA STORER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5609 DONNYBROOK AVE, TYLER, TX 75703-6111
(903) 561-2808
(903) 561-2868
Mailing address
2937 FM 3135 E, HENDERSON, TX 75652-8949
(903) 312-4925
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2063126
TX
Other
Enumeration date
06/04/2007
Last updated
07/31/2007
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