Provider Demographics
NPI:1164500344
Name:PHILLIPS, AMANDA ANN (PT)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:ANN
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18214 WINDWARD RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44119-1755
Mailing Address - Country:US
Mailing Address - Phone:216-531-4551
Mailing Address - Fax:
Practice Address - Street 1:35010 CHARDON RD
Practice Address - Street 2:STE 100
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-9010
Practice Address - Country:US
Practice Address - Phone:440-951-1910
Practice Address - Fax:440-951-1940
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist