| Doctor Name: | AMANDA PETERSON |
| NPI Number: | 1922408129 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | PTH7268 |
| Business Practice Address: | 205 Country Club Park Mountain Brk, AL - 352134237 |
| Business Phone Number: | 2058710777 |
| Business Fax Number: | 2058710701 |
| Mailing Address: | 2807 Greystone Comm Blvd, Suite 34 BIRMINGHAM |
| State: | AL |
| Postal Code: | 352429601 |
| Phone Number: | 2057453660 |
| Fax Number: | 2054084209 |
| NPI Enumeration Date: | 08/26/2014 |
| NPI Last Update Date: | 08/26/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PTH7268 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| 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 |