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General NPI Number Information
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NPI Number | 1215361795
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Entity Type | Individual
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Provider Name | AMANDA SCHALL AMMERMAN DPT
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Gender | Female
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Dates
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Enumeration Date | 09/03/2013
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Last Update Date | 01/13/2015
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Provider Practice Location Address
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Address Line | 1800 DAISY STREET EXT SUITE 360
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City | CLEARFIELD
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State | PA
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Zip | 16830-3254
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Country | US
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Telephone | 814-205-4043
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Fax | 814-205-4055
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Provider Business Mailing Address
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Address Line | 430 INNOVATION DRIVE
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City | BLAIRSVILLE
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State | PA
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Zip | 15717-8096
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Country | US
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Telephone | 724-343-4060
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Fax | 724-343-4069
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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 | PT018239
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License Number State | PA
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