MEDICARE: AMANDA DAY RCP,CRT

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	2278H0200X	Home Health Certified Respiratory Therapist	RCP00073614	TX

General Provider Information

NPI Number	:	1538812193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA DAY RCP,CRT

Provider Business Mailing Address
First Line	:	4900 TRAIL CREEK DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-6525
Country	:	US
Telephone Number	:	817-939-3462
Fax Number	:	817-562-2048

Provider Business Practice Location Address
First Line	:	1920 E STATE HIGHWAY 114
Second Line	:
City	:	SOUTHLAKE
State	:	TX
Zip	:	76092-6510
Country	:	US
Telephone Number	:	855-636-5486
Fax Number	:	817-562-2048

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

Provider Enumeration Date	:	02/02/2022
Last Update Date	:	02/02/2022

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