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General NPI Number Information
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NPI Number | 1386256543
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Entity Type | Individual
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Provider Name | AMANDA LOGAN MARCIC
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Gender | Female
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Dates
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Enumeration Date | 08/19/2020
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 110 CANAL ST STE 3
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City | LOWELL
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State | MA
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Zip | 01852-4589
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Country | US
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Telephone | 888-855-2674
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Fax |
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Provider Business Mailing Address
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Address Line | 103 FOX DEN CT
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City | CARY
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State | NC
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Zip | 27513-9100
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Country | US
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Telephone | 614-519-2024
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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 | CP035261T
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P23013
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT36121
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP037185T
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP035282T
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License Number State | NH
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Taxonomy #6
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP035281T
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License Number State | NJ
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