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General NPI Number Information
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NPI Number | 1093556979
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Entity Type | Individual
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Provider Name | AMANDA ROBERTS DPT
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Gender | Female
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Dates
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Enumeration Date | 06/04/2024
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Last Update Date | 06/12/2024
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Provider Practice Location Address
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Address Line | 4247 W RIDGE RD
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City | ERIE
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State | PA
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Zip | 16506-1746
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Country | US
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Telephone | 814-833-2468
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Fax |
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Provider Business Mailing Address
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Address Line | 2920 WALNUT ST
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City | ERIE
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State | PA
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Zip | 16508-1729
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Country | US
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Telephone | 716-868-7518
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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 |
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License Number State |
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