John Amantea, LPTA

Individual provider Active NPI Physical Therapy Assistant · Centreville, VA

NPI 1669745360 · NPPES record last updated Feb 12, 2012

Key facts

NPI
1669745360
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2306602571 (VA)
Practice address
14425 Four Chimney Dr
Centreville, VA 20120-3220
Phone
(571) 245-7273
NPI assigned
Feb 12, 2012
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2306602571VAMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2306602571 VA Yes

Addresses

Primary practice location

14425 Four Chimney Dr
Centreville, VA 20120-3220

Mailing address

14425 Four Chimney Dr
Centreville, VA 20120-3220

Other providers in Centreville, VA

All providers in Centreville, VA · Physical Therapy Assistant in Virginia

Sources for this page

Verify at the official NPI Registry.