MEDICARE: AMANDA DEWITT 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
1	225100000X	Physical Therapist	12501	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770037954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA DEWITT DPT

Provider Business Mailing Address
First Line	:	9097 E DESERT COVE AVE STE 110
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85260-6276
Country	:	US
Telephone Number	:	480-565-1897
Fax Number	:

Provider Business Practice Location Address
First Line	:	15800 N LITCHFIELD RD STE 130
Second Line	:
City	:	SURPRISE
State	:	AZ
Zip	:	85374-5516
Country	:	US
Telephone Number	:	623-400-9000
Fax Number	:	623-400-9001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2016
Last Update Date	:	10/29/2025

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