Healthcare Provider Details

I. General information

NPI: 1689311417
Provider Name (Legal Business Name): AMANDA ALLENE LOCHTE PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2022
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 CONGRESS ST
PORTLAND ME
04102-2102
US

IV. Provider business mailing address

4688 CENTER POINT RD
FREDERICKSBURG TX
78624-8318
US

V. Phone/Fax

Practice location:
  • Phone: 207-774-5710
  • Fax:
Mailing address:
  • Phone: 830-992-1470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT7171
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: