| Amanda M Minick, PT | |
|
1043 Jack Vest Dr, Johnson City, TN 37614 | |
| (423) 439-4044 | |
| Not Available |
| Full Name | Amanda M Minick |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 1043 Jack Vest Dr, Johnson City, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063429462 | NPI | - | NPPES |
| 7211956 | Medicaid | NC | |
| 188109 | Other | NC | MEDCOST |
| Q033316 | Medicaid | TN | |
| 079Y3 | Other | NC | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 10335 (North Carolina) | Secondary |
| 225100000X | Physical Therapist | 10010 (Tennessee) | Primary |
| Provider Name | Medical Education Assistance Corporation |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1235180480 PECOS PAC ID: 3870491269 Enrollment ID: O20040206000795 |
| Provider Name | Champion Physical Therapy Llc Halls |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1073771564 PECOS PAC ID: 1355416306 Enrollment ID: O20120619000128 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda M Minick, PT Po Box 699, Mountain Home, TN 37684-0699 Ph: () - | Amanda M Minick, PT 1043 Jack Vest Dr, Johnson City, TN 37614 Ph: (423) 439-4044 |
Lauren Hope Campbell, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 3915 Bristol Hwy Ste 301, Johnson City, TN 37601 Phone: 423-556-8943 | |
Alexis Beach, Physical Therapist Medicare: Medicare Enrolled Practice Location: 2312 Knob Creedk Rd Ste 200, Johnson City, TN 37604 Phone: 423-232-8302 | |
Dr. Hannah Michelle Johnson, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 406 E Mountain View Rd, Johnson City, TN 37601 Phone: 423-291-0234 | |
Jacqueline Ann White, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 612 Lyle St Ste 118, Johnson City, TN 37604 Phone: 423-328-3156 | |
Jessica Story, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3209 Bristol Hwy, Johnson City, TN 37601 Phone: 423-282-3311 | |
Olivia Cathryn Boles, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 3135 Peoples St Ste 404, Johnson City, TN 37604 Phone: 423-454-1006 |