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NPI Code Detail

MEDICARE: AMANDA LAXGANGER PT, DPT

MEDICARE: AMANDA LAXGANGER PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT020893OH

General Provider Information

NPI Number : 1427816636
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA LAXGANGER PT, DPT
Provider Business Mailing Address
First Line : 3296 ROYALTON RD
Second Line :
City : NORTH ROYALTON
State : OH
Zip : 44133-5210
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7390 OLD OAK BLVD
Second Line :
City : MIDDLEBURG HEIGHTS
State : OH
Zip : 44130-3328
Country : US
Telephone Number : 440-816-4202
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2024
Last Update Date : 03/12/2024

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Directions to “ AMANDA LAXGANGER PT, DPT” Practice Location

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