Provider Demographics
NPI:1073953949
Name:HUNT, AMANDA R (RPT)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:R
Last Name:HUNT
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 82 BOX 302A2
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:65650-9661
Mailing Address - Country:US
Mailing Address - Phone:417-282-5253
Mailing Address - Fax:
Practice Address - Street 1:2011 CORONA RD
Practice Address - Street 2:SUITE 301
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-2548
Practice Address - Country:US
Practice Address - Phone:314-543-3860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003025344225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist