Provider Demographics
NPI:1831399187
Name:WEST, AMANDA ELIZABETH (MPT)
Entity type:Individual
Prefix:MISS
First Name:AMANDA
Middle Name:ELIZABETH
Last Name:WEST
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 BRITTANY LN
Mailing Address - Street 2:
Mailing Address - City:BONNEAU
Mailing Address - State:SC
Mailing Address - Zip Code:29431-8731
Mailing Address - Country:US
Mailing Address - Phone:843-860-0856
Mailing Address - Fax:
Practice Address - Street 1:2375 BAKER HOSPITAL BLVD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-8233
Practice Address - Country:US
Practice Address - Phone:843-744-2750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist