MEDICARE: AMANDA L GARNETT 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	2305208852	VA

General Provider Information

NPI Number	:	1780085969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA L GARNETT DPT

Provider Business Mailing Address
First Line	:	1115 BOULDERS PKWY
Second Line	:	SUITE 200
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23225-4067
Country	:	US
Telephone Number	:	804-560-5595
Fax Number	:	804-560-9029

Provider Business Practice Location Address
First Line	:	4710 PUDDLEDOCK RD
Second Line	:
City	:	PRINCE GEORGE
State	:	VA
Zip	:	23875-1269
Country	:	US
Telephone Number	:	804-285-2645
Fax Number	:	804-287-2786

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

Provider Enumeration Date	:	09/08/2014
Last Update Date	:	06/24/2020

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