Basic Information
| Provider Information | |||||||||
| NPI: | 1619223831 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TOWNSEND | ||||||||
| FirstName: | AMANDA | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | DPT | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | MCDANIEL | ||||||||
| OtherFirstName: | AMANDA | ||||||||
| OtherMiddleName: | L | ||||||||
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| OtherCredential: | DPT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 1769 | ||||||||
| Address2: | |||||||||
| City: | MIDDLEBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201181769 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5406878181 | ||||||||
| FaxNumber: | 5406878256 | ||||||||
| Practice Location | |||||||||
| Address1: | 6551 LOISDALE CT | ||||||||
| Address2: | SUITE 155 | ||||||||
| City: | SPRINGFIELD | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221501828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7038220039 | ||||||||
| FaxNumber: | 7038220211 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2012 | ||||||||
| LastUpdateDate: | 09/27/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT871381 | DC | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | PT.012917 | OH | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 2305207888 | VA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.