Individual ProviderAmanda M NolanPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address16815 S Desert Foothills Pkwy, Phoenix, AZ 85048-8401(480) 704-5954(740) 739-3896PECOS EnrollmentBased on the most recent information from CMS, provider Amanda M Nolan does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 15 days ago.Profile DetailsProvider ID1811427149Provider TypeIndividualFull NameNolan, Amanda MCredentialPTGenderFemaleSole ProprietorNoEnumeration Date6/19/2017Last Updated7/22/2020Contact InformationPractice LocationPractice Address16815 S Desert Foothills Pkwy, Phoenix, AZ 85048-8401Phone(480) 704-5954FaxUnlisted FaxMailing LocationMailing Address1673 N Marketside Ave, Buckeye, AZ 85396-2036Phone(740) 739-3896FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseLPT-013118Code225100000XDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicensePT016941Ohio