Individual
AMANDA JO FELLERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
401 E WASHINGTON AVE, SUITE 200, NAVASOTA, TX 77868-3047
(936) 870-3475
(936) 870-3476
Mailing address
PO BOX 11287, COLLEGE STATION, TX 77842-1287
(936) 870-3475
(936) 870-3476
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1165307
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159962301
—
TX
Enumeration date
10/23/2006
Last updated
04/23/2008
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