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Contact Information

AMANDA M MINICK, PT
1043 JACK VEST DR
JOHNSON CITY, TN37614
 Phone: 423-439-4044
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for AMANDA M MINICK · (Female)

NPI # 1063429462
Status Active
Credentials PT (Physical Therapist)
Entity Individual
Enumeration date 08/01/2006
Last updated 01/25/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 10335
  • TN License # 10010
  • NC Medicaid 7211956
  • TN Medicaid Q033316
  • NC Other 079Y3 BCBS
  • NC Other 188109 MEDCOST
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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