Individual
AMANDA LYNNE HARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1438 SW MAIN BLVD, LAKE CITY, FL 32025-1106
(386) 755-3164
Mailing address
19293 NW 230TH ST, HIGH SPRINGS, FL 32643-4157
(352) 339-3538
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA28364
FL
Other
Enumeration date
08/02/2018
Last updated
08/02/2018
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