Individual
AMANDA MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
114 WATERTOWER COURT, GOSHEN, IN 46526
(765) 635-0659
Mailing address
114 WATERTOWER CT, GOSHEN, IN 46526-1824
(765) 635-0659
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06005132A
IN
Other
Enumeration date
03/11/2016
Last updated
03/11/2016
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