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General NPI Number Information
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NPI Number | 1124350970
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Entity Type | Individual
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Provider Name | AMANDA GREENE PT
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Gender | Female
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Dates
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Enumeration Date | 02/04/2010
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 10803 FALLS ROAD PAVILION 3, SUITE 2100
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City | LUTHERVILLE
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State | MD
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Zip | 21093
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Country | US
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Telephone | 410-583-2666
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Fax | 301-540-5190
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Provider Business Mailing Address
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Address Line | 6201 GREENLEIGH AVE FL 2
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City | MIDDLE RIVER
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State | MD
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Zip | 21220-2004
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Country | US
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Telephone | 410-933-2704
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Fax | 410-500-4266
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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 | 23189
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License Number State | MD
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