Individual
AMANDA ROSE NIGHTINGALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DOC OF PHYSICAL THER
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1206819
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1206819
LICENSE NUMBER
TX
Enumeration date
01/10/2012
Last updated
01/10/2012
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