Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT13861 | NC |
N | 2251S0007X | Physical Therapist - Sports | PT13861 | NC |
NPI | 1013395631 |
---|---|
Provider Name | Amanda E Martin |
First Address | Asheville, NC 28814-0806 |
Second Address | Asheville, NC 28804-3456 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2015 |
Last Update Date | 14/05/2015 |