Individual
AMANDA CLEMENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
7938 GA HIGHWAY 21 STE 300, PORT WENTWORTH, GA 31407-9808
(912) 965-0601
Mailing address
6397 LEE HWY STE 300, CHATTANOOGA, TN 37421-4915
(423) 238-8923
(309) 672-4569
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070013744
IL
225100000X
Physical Therapist
Primary
PT016003
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01141585
RR MEDICARE
IL
Enumeration date
01/07/2008
Last updated
09/08/2022
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