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Individual

MISS AMANDA MARY JETTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.P.T

Contact information

Practice address
5424 DISCOVERY PARK BLVD, BLDG. B /STE. 101, WILLIAMSBURG, VA 23188
(757) 345-2512
Mailing address
860 OMNI BLVD STE 303, NEWPORT NEWS, VA 23606-4477
(757) 232-8769

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305208434
VA

Other

Enumeration date
06/16/2011
Last updated
07/03/2025
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