Individual
AMANDA KAYE BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
920 CAIRO RD, THOMASVILLE, GA 31792-4255
(229) 228-8800
Mailing address
11740 COLUMBIA ST, BLAKELY, GA 39823-2574
(229) 723-4241
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA002449
LICENSE
GA
Enumeration date
02/21/2008
Last updated
02/21/2008
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