Individual
AMANDA LYN MENINNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, DPT
Contact information
Practice address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 849-3465
Mailing address
4408 AUBURN DR, ROYAL OAK, MI 48073-6346
(781) 258-2190
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501017739
MI
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
02/28/2018
Last updated
02/28/2018
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