Individual provider · Type 1 NPI

Amanda Kristan Mirise, DPT

Pediatric Physical Therapist · Tyler, TX

NPI number 1497566624 Active

Practice location

100 E Ferguson St
Tyler, TX 75702-5759

Call (903) 509-2040 Map

Specialties and licenses

TaxonomyCodeLicense
Pediatric Physical Therapist Primary 2251P0200X1401088 (TX)

Pediatric Physical Therapist: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, genetics, biomechanics, neurological function, neuroscience, and pathology, behavioral sciences, and understanding of diseases or conditions that necessitate physical th…

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About NPI 1497566624

Amanda Kristan Mirise, DPT's National Provider Identifier is 1497566624, issued on Jan 16, 2025. The primary taxonomy on file is Pediatric Physical Therapist (2251P0200X), and the practice location is in Tyler, TX. The record was last updated on Jan 16, 2025.