Provider Demographics
NPI:1083930481
Name:KRYWONIS, AMANDA LYNNE (PT)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:LYNNE
Last Name:KRYWONIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:1235 BATTERY AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-4301
Mailing Address - Country:US
Mailing Address - Phone:301-641-6001
Mailing Address - Fax:410-448-6254
Practice Address - Street 1:2200 KERNAN DR
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21207-6665
Practice Address - Country:US
Practice Address - Phone:410-448-6318
Practice Address - Fax:419-448-6254
Is Sole Proprietor?:No
Enumeration Date:2010-04-12
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD211002251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology