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NPI Code Detail

MEDICARE: AMANDA NICOLE GOSS DPT

MEDICARE: AMANDA NICOLE GOSS 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 Therapist2305213302VA
2225100000XPhysical TherapistPT027924PA

General Provider Information

NPI Number : 1942858667
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA NICOLE GOSS DPT
Provider Business Mailing Address
First Line : 1200 CORPORATE DR STE 400
Second Line :
City : HOOVER
State : AL
Zip : 35242-5424
Country : US
Telephone Number : 423-702-4389
Fax Number :
Provider Business Practice Location Address
First Line : 3120 PLEASANT VALLEY BLVD
Second Line :
City : ALTOONA
State : PA
Zip : 16602-4309
Country : US
Telephone Number : 814-949-9550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2019
Last Update Date : 12/01/2025

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