| Doctor Name: | AMANDA JANDERNOA |
| NPI Number: | 1144642356 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT, DPT |
| License Number: | 5501016327 |
| Business Practice Address: | 1161 E Clark Rd Dewitt, MI - 488207930 |
| Business Phone Number: | 5176680000 |
| Business Fax Number: | |
| Mailing Address: | 1161 E Clark Rd, DEWITT |
| State: | MI |
| Postal Code: | 488207930 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/08/2014 |
| NPI Last Update Date: | 01/08/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 5501016327 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| 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 |