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Individual

AMANDA BUDACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
8815 E INDIAN BEND RD, STE 123, SCOTTSDALE, AZ 85250
(480) 951-6451
(630) 724-0978
Mailing address
8115 E INDIAN BEND RD, STE 123, SCOTTSDALE, AZ 85250
(480) 951-6451

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070015359
IL
225100000X
Physical Therapist
Primary
8812
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1619908
BCBS IL GROUP
IL
01
568080
MEDICARE GROUP NUMBER
IL
01
CD3789
MEDICARE RAILROAD GROUP NUMBER
IL
01
P00623070
MEDICARE RAILROAD NUMBER
IL
Enumeration date
08/21/2007
Last updated
11/13/2017
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