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NPI Code Detail

MEDICARE: AMANDA WORSTELL

MEDICARE: AMANDA WORSTELL
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 Therapist13004OH

General Provider Information

NPI Number : 1811311327
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA WORSTELL
Provider Business Mailing Address
First Line : 6170 VIA KEN RD
Second Line :
City : HOPEWELL
State : OH
Zip : 43746-9601
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 303 N HURSTBOURNE PKWY STE 200
Second Line :
City : LOUISVILLE
State : KY
Zip : 40222-5158
Country : US
Telephone Number : 502-412-5847
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2014
Last Update Date : 02/05/2014

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