Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 035353 | NY |
NPI | 1003165499 |
---|---|
Provider Name | Amanda E Sapp |
First Address | Utica, NY 13501-5405 |
Second Address | Chadwicks, NY 13319-3510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2012 |
Last Update Date | 25/10/2019 |