Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 2003 | NC |
NPI | 1124399639 |
---|---|
Provider Name | Mrs. Amanda Holliday Spencer |
First Address | Asheboro, NC 27205-2542 |
Second Address | Asheboro, NC 27205-2542 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2012 |
Last Update Date | 16/01/2012 |