Individual
AMANDA ELIZABETH TYSON BROADWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3500 LENOX RD NE STE 1500, ATLANTA, GA 30326-4231
(877) 407-3422
Mailing address
7 CARNEGIE PLZ, CHERRY HILL, NJ 08003-1000
(877) 407-3422
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT003732
GA
Other
Enumeration date
09/29/2021
Last updated
03/22/2024
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