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Individual

MRS. AMANDA G PILZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MPT

Contact information

Practice address
3890 HIGHWAY 81, LOGANVILLE, GA 30052-3917
(770) 554-7977
(770) 554-4177
Mailing address
3890 HIGHWAY 81, LOGANVILLE, GA 30052-3917
(770) 554-7977
(770) 554-4177

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6777
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1386659894
PROMOTION PHYSICAL THERAPY FACILITY NPI
GA
01
582654830
BLUE CROSS BLUE SHIELD
GA
01
GRP PIN 821337
BLUE CROSS BLUE SHIELD
01
GRP4351
MEDICARE GRP
Enumeration date
04/12/2006
Last updated
06/24/2008
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