MEDICARE: AMANDA GOODALE P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	15057	MA

General Provider Information

NPI Number	:	1447303292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA GOODALE P.T.

Provider Business Mailing Address
First Line	:	20 EAST ST
Second Line	:	ANDERSON PHYSICAL THERAPY
City	:	HANOVER
State	:	MA
Zip	:	02339-1638
Country	:	US
Telephone Number	:	781-826-8309
Fax Number	:	781-826-3610

Provider Business Practice Location Address
First Line	:	20 EAST ST
Second Line	:	ANDERSON PHYSICAL THERAPY
City	:	HANOVER
State	:	MA
Zip	:	02339-1638
Country	:	US
Telephone Number	:	781-826-8309
Fax Number	:	781-826-3610

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	01/15/2020

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Directions to “ AMANDA GOODALE P.T.” Practice Location

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