Healthcare Provider Details

I. General information

NPI: 1649565847
Provider Name (Legal Business Name): AMANDA HECHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5535 S WILLIAMSON BLVD #774
PORT ORANGE FL
32128-8311
US

IV. Provider business mailing address

94 W MAIN ST
FREWSBURG NY
14738-9631
US

V. Phone/Fax

Practice location:
  • Phone: 800-330-7711
  • Fax: 866-426-2811
Mailing address:
  • Phone: 800-330-7711
  • Fax: 866-426-2811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9216
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number06511
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: