Individual
MS. AMANDA KELLY SOUTHWOOD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
1326 EISENHOWER DR, SAVANNAH, GA 31406-3928
(912) 691-4250
(912) 691-4254
Mailing address
1326 EISENHOWER DR, SAVANNAH, GA 31406-3928
(912) 691-4250
(912) 691-4254
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT008334
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
392723
BCBS
GA
Enumeration date
07/15/2005
Last updated
07/08/2007
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