MEDICARE: MS. AMANDA NICOLE ZWAHR 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	1164046	TX

General Provider Information

NPI Number	:	1700043601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AMANDA NICOLE ZWAHR P.T.

Provider Business Mailing Address
First Line	:	14500 BLANCO RD
Second Line	:	APT 222
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-7858
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14500 BLANCO RD
Second Line	:	APT 222
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-7858
Country	:	US
Telephone Number	:	210-358-2620
Fax Number	:

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

Provider Enumeration Date	:	05/19/2008
Last Update Date	:	05/19/2008

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