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Individual

AMANDA FROST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
201 W MADISON AVE, JOHNSTOWN, NY 12095-2806
(518) 762-4548
(518) 736-1570
Mailing address
201 W MADISON AVE, JOHNSTOWN, NY 12095-2806
(518) 762-4548
(518) 736-1570

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
038646-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00394849
NY
01
10035694
CDPHP
NY
01
353581
MVP
NY
01
Q44191
EBCBS
NY
Enumeration date
01/03/2017
Last updated
01/03/2017
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