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Individual

AMANDA BASTIEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2011 GRINSTEAD DR UNIT 101, LOUISVILLE, KY 40204-1296
(502) 813-7838
(502) 813-7839
Mailing address
PO BOX 306393, NASHVILLE, TN 37230-6393
(615) 373-1350
(615) 221-9054

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
007422
KY

Other

Enumeration date
06/06/2018
Last updated
09/20/2021
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