Healthcare Provider Details

I. General information

NPI: 1609514207
Provider Name (Legal Business Name): AMANDA BECKER PT, DPT, CSCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2022
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 W 11TH ST
FRONT ROYAL VA
22630-3512
US

IV. Provider business mailing address

140 W 11TH ST
FRONT ROYAL VA
22630-3512
US

V. Phone/Fax

Practice location:
  • Phone: 540-636-5590
  • Fax: 833-455-6472
Mailing address:
  • Phone: 540-636-5590
  • Fax: 833-455-6472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number2305214965
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: