Amanda Maryam Agbannawag, DPT
Physical Therapist in Tucson, AZ. Individual provider (NPI-1).
NPI number1255805727
StatusActive
Last updated in NPPESJul 14, 2022
Details
- NPI
- 1255805727
- Entity type
- Individual (NPI-1)
- Name
- Amanda Maryam Agbannawag
- Credential
- DPT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 17, 2019
- Certification date
- Jul 14, 2022
- Last updated
- Jul 14, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | LPT-30412 | AZ | Yes |
Other names
- Mandy Dorri (Former Name)
Practice location
3988 E Fort Lowell RdTucson, AZ 85712-1010
Phone 520-488-5291
Mailing address
3988 E Fort Lowell RdTucson, AZ 85712-1010
Phone 520-488-5291 · Fax 520-689-6810
Other practice locations
10445 N Oracle Rd
Tucson, AZ 85737-9358
Tucson, AZ 85737-9358
Phone 520-488-5291 · Fax 520-689-6810
6264 E Grant Rd
Tucson, AZ 85712-5882
Tucson, AZ 85712-5882
Phone 520-884-0001 · Fax 520-884-0199
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