Doctor Name: | MISS AMANDA NICOLE CONGLETON |
NPI Number: | 1073825626 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | PT009966 |
Business Practice Address: | 595 Hurricane Shoals Road, Nw Suite 100 Lawrenceville, GA - 30045 |
Business Phone Number: | 6782055420 |
Business Fax Number: | 6782055462 |
Mailing Address: | 595 Hurricane Shoals Road, Nw, Suite 100 LAWRENCEVILLE |
State: | GA |
Postal Code: | 30045 |
Phone Number: | 6782055420 |
Fax Number: | 6782055462 |
NPI Enumeration Date: | 07/12/2010 |
NPI Last Update Date: | 07/12/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT009966 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |