Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT013604L | PA |
NPI | 1003205022 |
---|---|
Provider Name | Amanda Betler |
First Address | Oakmont, PA 15139-1709 |
Second Address | Huntingdon, PA 16652-1518 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2015 |
Last Update Date | 14/01/2015 |