Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | ||
N | 2251S0007X | Physical Therapist - Sports | PT40QA01043200 | NJ |
N | 2251X0800X | Physical Therapist - Orthopedic |
NPI | 1508877655 |
---|---|
Provider Name | Mrs. Amanda Joy Huggard |
First Address | Cherry Hill, NJ 08003-1279 |
Second Address | Cherry Hill, NJ 08003-1279 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 12/12/2007 |