Provider Demographics
NPI:1518211127
Name:OWENS, AMANDA
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3533 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FINLEYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15332-1307
Mailing Address - Country:US
Mailing Address - Phone:412-767-5967
Mailing Address - Fax:
Practice Address - Street 1:3390 SAXONBURG BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:GLENSHAW
Practice Address - State:PA
Practice Address - Zip Code:15116-3160
Practice Address - Country:US
Practice Address - Phone:412-767-5967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT022443225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist