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Individual

AMANDA VITRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
2209 GENESEE ST, UTICA, NY 13501-5930
(518) 694-1949
Mailing address
374 MADISON ST APT 6, WATERVILLE, NY 13480-1183
(518) 694-1949

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
042098
NY
2251P0200X
Pediatric Physical Therapist
042098
NY

Other

Enumeration date
08/23/2017
Last updated
03/27/2020
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