| Amanda Rose Vander Wiel, OT R/L | |
|
706 La Joya St, Espanola, NM 87532-2877 | |
| (732) 770-6838 | |
| Not Available |
| Full Name | Amanda Rose Vander Wiel |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist |
| Location | 706 La Joya St, Espanola, New Mexico |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700449931 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | 4091 (New Mexico) | Primary |
| Provider Name | Espanola Sports Medicine Pa |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1982777850 PECOS PAC ID: 2163691411 Enrollment ID: O20141114001053 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Rose Vander Wiel, OT R/L 144 Heyer Rd, Nazareth, PA 18064-8773 Ph: (732) 770-6838 | Amanda Rose Vander Wiel, OT R/L 706 La Joya St, Espanola, NM 87532-2877 Ph: (732) 770-6838 |
Theresa Ann Guenard, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 405 Hunter St, Espanola, NM 87532 Phone: 505-753-2254 | |
Kristina Sampsel, MOTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 417 Calle Don Diego, Espanola, NM 87532 Phone: 505-753-2254 | |
Deborah Ann Schmalbach, O.T. Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 714 Calle Don Diego, Espanola, NM 87532 Phone: 505-367-3342 | |
Ms. Anna Maria Rivera, O.T. Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 714 Calle Don Diego, Espanola, NM 87532 Phone: 505-367-3362 | |
Haley Allen, Occupational Therapist Medicare: Medicare Enrolled Practice Location: 405 Hunter St, Espanola, NM 87532 Phone: 618-447-2422 |