Individual
MS. AMANDA WHITEHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
957 MARINE DR, ANNAPOLIS, MD 21409-4745
(410) 507-9108
Mailing address
957 MARINE DR, ANNAPOLIS, MD 21409-4745
(410) 507-9108
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A3965
MD
Other
Enumeration date
04/02/2015
Last updated
04/02/2015
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