Individual
AMANDA B TRUCKSESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1850 TOWN CENTER PKWY, SUITE 400, RESTON, VA 20190-3219
(703) 810-5202
Mailing address
11240 WAPLES MILL RD 403, FAIRFAX, VA 22030-6078
(703) 383-6424
(703) 810-5369
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0101243539
VA
390200000X
Student in an Organized Health Care Education/Training Program
0116016644
VA
Other
Enumeration date
05/08/2007
Last updated
09/17/2020
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