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General NPI Number Information
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NPI Number | 1851558209
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Entity Type | Individual
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Provider Name | AMANDA RUDROFF PT
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Gender | Female
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 04/09/2020
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Provider Practice Location Address
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Address Line | 1951 E JACQUELINE ST
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City | SPRINGFIELD
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State | MO
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Zip | 65804-4365
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Country | US
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Telephone | 573-690-6222
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Fax |
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Provider Business Mailing Address
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Address Line | 1951 E JACQUELINE ST
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City | SPRINGFIELD
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State | MO
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Zip | 65804-4365
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Country | US
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Telephone |
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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 |
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License Number State |
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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 | 7565
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License Number State | MN
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