Provider Demographics
NPI:1356326680
Name:KUHARIK, AMANDA M (DC, DPT)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:M
Last Name:KUHARIK
Suffix:
Gender:F
Credentials:DC, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:FARRELL
Mailing Address - State:PA
Mailing Address - Zip Code:16121-1357
Mailing Address - Country:US
Mailing Address - Phone:724-983-7176
Mailing Address - Fax:724-983-7985
Practice Address - Street 1:2200 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:FARRELL
Practice Address - State:PA
Practice Address - Zip Code:16121-1357
Practice Address - Country:US
Practice Address - Phone:724-983-7176
Practice Address - Fax:724-983-7985
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008061L111N00000X
OHPT013723225100000X
PAPT022006225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019486160004Medicaid
PA0019486160004Medicaid
PA054785PVDMedicare PIN