Healthcare Provider Details

I. General information

NPI: 1568860674
Provider Name (Legal Business Name): AMANDA W SAYERS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA SAYERS HUBER PT

II. Dates (important events)

Enumeration Date: 12/06/2014
Last Update Date: 12/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4710 PUDDLEDOCK RD SUITE 100
PRINCE GEORGE VA
23875-1269
US

IV. Provider business mailing address

1115 BOULDERS PKWY SUITE 200
NORTH CHESTERFIELD VA
23225-4067
US

V. Phone/Fax

Practice location:
  • Phone: 804-732-0055
  • Fax: 804-287-2786
Mailing address:
  • Phone: 804-560-5595
  • Fax: 804-560-9029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number2305208780
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: