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Individual

AMANDA MARIE PAVLAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
12400 HIGH BLUFF DR, SAN DIEGO, CA 92130-3077
(866) 871-8519
Mailing address
12400 HIGH BLUFF DR, SAN DIEGO, CA 92130-3077
(866) 871-8519

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
06006385A
IN
225200000X
Physical Therapy Assistant
2181
CT
225200000X
Physical Therapy Assistant
Primary
PTA012171
OH

Other

Enumeration date
06/11/2021
Last updated
10/08/2021
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