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Individual

AMANDA BIETZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
3270 LIBERTY RD S, SALEM, OR 97302-4560
(503) 371-0779
Mailing address
3270 LIBERTY RD S, SALEM, OR 97302-4560
(503) 371-0779

Taxonomy

Speciality
Code
Description
License number
State
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
Primary
62897
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
62897
OREGON STATE LICENSE
OR
Enumeration date
09/06/2018
Last updated
09/06/2018
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