Provider Demographics
NPI:1558849398
Name:KRZYZANOWSKI, AMANDA ELAINE (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:ELAINE
Last Name:KRZYZANOWSKI
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 GOLDFINCH LN UNIT 5
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-4724
Mailing Address - Country:US
Mailing Address - Phone:219-816-2200
Mailing Address - Fax:
Practice Address - Street 1:1375 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-1656
Practice Address - Country:US
Practice Address - Phone:219-816-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program