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General NPI Number Information
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NPI Number | 1427367200
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Entity Type | Individual
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Provider Name | AMANDA WEMYSS PHYSICAL THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 09/28/2010
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Last Update Date | 09/28/2010
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Provider Practice Location Address
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Address Line | 2100 PARK PLAZA DR
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City | SPRINGFIELD
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State | TN
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Zip | 37172-3937
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Country | US
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Telephone | 615-384-0687
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Fax |
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Provider Business Mailing Address
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Address Line | 280 ADAIRVILLE RD
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City | FRANKLIN
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State | KY
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Zip | 42134-9455
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Country | US
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Telephone | 270-586-5730
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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 | 1419
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License Number State | TN
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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 | 4166
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License Number State | KY
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