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Individual

AMANDA LEE FLEMING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
389 KANE STREET, GATE CITY, VA 24251
(276) 386-2424
(276) 386-2349
Mailing address
PO BOX 1807, GATE CITY, VA 24251
(276) 386-2424
(276) 386-1446

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2305204535
VA
225100000X
Physical Therapist
6604
TN
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
2305204535
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004979681
VA
05
4979681
VA
Enumeration date
04/16/2008
Last updated
10/25/2021
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