Provider Demographics
NPI:1295397743
Name:TOTTEN, AMANDA M (ATC, PT, DPT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:M
Last Name:TOTTEN
Suffix:
Gender:
Credentials:ATC, PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3942 DAVIS STUART RD STE 3
Mailing Address - Street 2:
Mailing Address - City:RONCEVERTE
Mailing Address - State:WV
Mailing Address - Zip Code:24970-0269
Mailing Address - Country:US
Mailing Address - Phone:304-647-3987
Mailing Address - Fax:304-647-3990
Practice Address - Street 1:3942 DAVIS STUART RD STE 3
Practice Address - Street 2:
Practice Address - City:RONCEVERTE
Practice Address - State:WV
Practice Address - Zip Code:24970-0269
Practice Address - Country:US
Practice Address - Phone:304-647-3987
Practice Address - Fax:304-647-3990
Is Sole Proprietor?:No
Enumeration Date:2019-07-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPT004152208100000X
VACP003607T208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation