Individual
MRS. AMANDA MICHELLE UTTERBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
925 SANTA FE DR STE 111, WEATHERFORD, TX 76086-5867
(817) 594-9200
Mailing address
9117 NATHAN DR, WHITE SETTLEMENT, TX 76108-3551
(806) 470-1192
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1175159
TX
Other
Enumeration date
06/13/2007
Last updated
07/18/2007
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