Individual
AMANDA INGERSOLL BREEDLOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
8469 SHERIDAN DR, WILLIAMSVILLE, NY 14221-4133
(716) 498-2677
Mailing address
8469 SHERIDAN DR, WILLIAMSVILLE, NY 14221-4133
(301) 461-2090
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
045822
NY
225100000X
Physical Therapist
2305209456
VA
225100000X
Physical Therapist
27209
MD
Other
Enumeration date
07/27/2018
Last updated
08/20/2020
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