Healthcare Provider Details

I. General information

NPI: 1750698437
Provider Name (Legal Business Name): AMANDA CRIGGER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2010
Last Update Date: 01/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3848 FAU BLVD SUITE 105
BOCA RATON FL
33431-6437
US

IV. Provider business mailing address

3848 FAU BLVD SUITE 105
BOCA RATON FL
33431-6437
US

V. Phone/Fax

Practice location:
  • Phone: 561-395-2920
  • Fax: 561-395-2960
Mailing address:
  • Phone: 561-395-2920
  • Fax: 561-395-2960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT25813
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: