Healthcare Provider Details

I. General information

NPI: 1942265251
Provider Name (Legal Business Name): AMANDA E. WEBER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 03/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 COMMERCE PARK N SUITE 103
BEDFORD NH
03110-6911
US

IV. Provider business mailing address

171 DANIEL WEBSTER HWY UNIT 11
BELMONT NH
03220-3053
US

V. Phone/Fax

Practice location:
  • Phone: 603-472-5546
  • Fax:
Mailing address:
  • Phone: 603-524-3397
  • Fax: 603-524-9364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2232
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11964
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: