Individual
AMANDA NICOLE HAVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
5385 HERITAGE DR, NASHPORT, OH 43830
(740) 624-3792
Mailing address
5385 HERITAGE DR, NASHPORT, OH 43830-9717
(740) 624-3792
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
014155
OH
Other
Enumeration date
07/22/2015
Last updated
08/13/2018
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