Healthcare Provider Details

I. General information

NPI: 1386931087
Provider Name (Legal Business Name): AMANDA LINDSAY MARTZ M.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2011
Last Update Date: 07/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3540 WASHINGTON RD
MC MURRAY PA
15317-2957
US

IV. Provider business mailing address

3540 WASHINGTON RD
MC MURRAY PA
15317-2957
US

V. Phone/Fax

Practice location:
  • Phone: 724-941-7070
  • Fax: 724-941-7033
Mailing address:
  • Phone: 724-941-7070
  • Fax: 724-941-7033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT013593L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: