Individual
MR. AMIE NICOLE MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
650 N JEFFERSON ST, ROANOKE, VA 24016-1427
(540) 343-3484
Mailing address
765 AGNES LN NW, WILLIS, VA 24380-4600
(540) 789-8090
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306001726
VA
Other
Enumeration date
04/25/2007
Last updated
07/08/2007
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