Amanda M Whitlock, MSPT
Physical Therapist in Grand Rapids, MI. Individual provider (NPI-1).
NPI number1013166339
StatusActive
Last updated in NPPESJun 25, 2018
Details
- NPI
- 1013166339
- Entity type
- Individual (NPI-1)
- Name
- Amanda M Whitlock
- Credential
- MSPT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 10, 2008
- Last updated
- Jun 25, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 55010129933 | MI | Yes |
| 225100000X | Physical Therapist | 070-018957 | IL |
Practice location
4120 E Beltline Ave NeSuite 200
Grand Rapids, MI 49525-9655
Phone 616-365-2709 · Fax 616-975-9248
Mailing address
4761 Lake Michigan Dr Nw Ste AGrand Rapids, MI 49534-6300
Phone 616-791-7025
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