Individual
MRS. AMANDA SUPECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/ L
Contact information
Practice address
640 HANNINGS LN, MARTIN, TN 38237-3308
(731) 587-3193
Mailing address
3447 LIBERTY RD, DRESDEN, TN 38225-2430
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2629
TN
Other
Enumeration date
06/10/2013
Last updated
06/10/2013
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