Individual
AMANDA J. STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05012833A
IN
225100000X
Physical Therapist
070-016207
IL
225100000X
Physical Therapist
10757
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00727597
MEDICARE RR
IL
01
—
P01055745
MEDICARE RAILROAD
IL
Enumeration date
01/18/2007
Last updated
09/21/2020
Update your record
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