Individual
AMANDA E ELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.D.P.T.
Contact information
Practice address
130 HOSPITAL RD, SUITE 103, PRINCE FREDERICK, MD 20678-4015
(410) 535-8180
Mailing address
130 HOSPITAL RD, SUITE 103, PRINCE FREDERICK, MD 20678-4015
(410) 535-8180
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
23508
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
406409700
—
MD
Enumeration date
01/18/2011
Last updated
01/18/2011
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