Provider Demographics
NPI:1821227265
Name:IRELAND, AMANDA MARIE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:MARIE
Last Name:IRELAND
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:MARIE
Other - Last Name:PENDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:659 S SALISBURY BLVD STE 1B
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-5458
Mailing Address - Country:US
Mailing Address - Phone:410-831-3226
Mailing Address - Fax:410-572-4041
Practice Address - Street 1:21 W CLARKE AVE STE 1500
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1857
Practice Address - Country:US
Practice Address - Phone:302-491-6529
Practice Address - Fax:302-503-7160
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0002833225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist