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General NPI Number Information
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NPI Number | 1013627413
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Entity Type | Individual
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Provider Name | AMANDA ISEN DPT
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Gender | Female
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Dates
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Enumeration Date | 11/28/2022
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 1727 KING ST STE 300
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City | ALEXANDRIA
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State | VA
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Zip | 22314-2761
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Country | US
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Telephone | 202-335-7151
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Fax |
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Provider Business Mailing Address
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Address Line | 13 HERBERT ST
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City | ALEXANDRIA
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State | VA
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Zip | 22305-2629
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Country | US
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Telephone | 608-628-4571
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 29248
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License Number State | MD
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