Provider Demographics
NPI:1083900112
Name:CHEROK, AMANDA JO (PT, DPT)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:JO
Last Name:CHEROK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:JO
Other - Last Name:STRITTMATTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:PO BOX 933
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:AK
Mailing Address - Zip Code:99603-0933
Mailing Address - Country:US
Mailing Address - Phone:814-242-0110
Mailing Address - Fax:
Practice Address - Street 1:601 E PIONEER AVE STE 218
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:AK
Practice Address - Zip Code:99603-7694
Practice Address - Country:US
Practice Address - Phone:907-235-7473
Practice Address - Fax:907-205-5370
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKPHYP2590225100000X
AK2590225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist