Provider Demographics
NPI:1336669662
Name:LOOS, AMANDA CAROL (DPT)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:CAROL
Last Name:LOOS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:CAROL
Other - Last Name:BUSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:608 NORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-3708
Mailing Address - Country:US
Mailing Address - Phone:615-695-1455
Mailing Address - Fax:615-695-1483
Practice Address - Street 1:270 E MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-3067
Practice Address - Country:US
Practice Address - Phone:615-278-1673
Practice Address - Fax:615-278-1672
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist