Individual
AMANDA TIEKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
11315 CORPORATE BLVD STE 100, ORLANDO, FL 32817-8340
(502) 657-9877
Mailing address
8807 SHELBYVILLE RD, INDIANAPOLIS, IN 46259-9695
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
005800
KY
225100000X
Physical Therapist
Primary
05010550A
IN
Other
Enumeration date
08/12/2011
Last updated
08/12/2011
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