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General NPI Number Information
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NPI Number | 1770913337
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Entity Type | Individual
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Provider Name | AMANDA MCDONALD DPT
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Gender | Female
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Dates
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Enumeration Date | 11/19/2013
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Last Update Date | 12/20/2017
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Provider Practice Location Address
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Address Line | 1500 GRAND CENTRAL AVE SUITE 101
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City | VIENNA
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State | WV
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Zip | 26105-1079
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Country | US
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Telephone | 304-295-3060
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Fax | 304-295-3068
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Provider Business Mailing Address
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Address Line | 809 FARSON ST SUITE 105
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City | BELPRE
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State | OH
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Zip | 45714-1066
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Country | US
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Telephone | 740-423-1507
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Fax | 740-401-0660
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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 | PT 003249
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License Number State | WV
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