Provider Demographics
NPI:1063925899
Name:DESHLER, AMANDA BRITT (PT)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:BRITT
Last Name:DESHLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4705 TURNBERRY DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-9589
Mailing Address - Country:US
Mailing Address - Phone:540-273-9608
Mailing Address - Fax:
Practice Address - Street 1:7320 SMITH STATION RD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-1738
Practice Address - Country:US
Practice Address - Phone:540-273-9608
Practice Address - Fax:540-273-9608
Is Sole Proprietor?:No
Enumeration Date:2017-11-15
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305004972225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist