Provider Demographics
NPI:1639352925
Name:MCCURRY, AMANDA MARIE (PTA)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIE
Last Name:MCCURRY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27829 HIGHWAY F
Mailing Address - Street 2:
Mailing Address - City:SAINT CATHARINE
Mailing Address - State:MO
Mailing Address - Zip Code:64628-7922
Mailing Address - Country:US
Mailing Address - Phone:816-294-8275
Mailing Address - Fax:
Practice Address - Street 1:27829 HIGHWAY F
Practice Address - Street 2:
Practice Address - City:SAINT CATHARINE
Practice Address - State:MO
Practice Address - Zip Code:64628-7922
Practice Address - Country:US
Practice Address - Phone:816-294-8275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-10
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004030579225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant