Provider Demographics
NPI:1730065095
Name:FITTS, AMANDA LAYNE (PT, DPT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LAYNE
Last Name:FITTS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1429 BRYANT ST STE A
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-5201
Mailing Address - Country:US
Mailing Address - Phone:704-919-0867
Mailing Address - Fax:704-817-8579
Practice Address - Street 1:9405 BRYANT FARMS RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-1642
Practice Address - Country:US
Practice Address - Phone:980-207-2707
Practice Address - Fax:980-207-2783
Is Sole Proprietor?:No
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP24325225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist