Individual
AMANDA BEAUFORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
25502 AMBER GATE TER, CHANTILLY, VA 20152-5792
(973) 699-4794
Mailing address
25502 AMBER GATE TER, CHANTILLY, VA 20152-5792
(973) 699-4794
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305208502
VA
Other
Enumeration date
07/31/2014
Last updated
05/11/2020
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