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Individual

MS. AMANDA L GEORGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
1301 RUSSELL ROAD, RUSSELLVILLE, AR 72802
(479) 967-2322
(479) 968-2876
Mailing address
PO DRAWER 2109, RUSSELLVILLE, AR 72811-2109
(479) 967-2322
(479) 967-2876

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR770
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
130041721
AR
01
5W516
BLUE CROSS BLUE SHIELD
AR
Enumeration date
03/27/2007
Last updated
01/06/2023
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