Provider Demographics
NPI:1891073235
Name:HANFF, AMANDA P (DPT)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:P
Last Name:HANFF
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2223
Mailing Address - Fax:
Practice Address - Street 1:1051 STAMP CREEK RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:SC
Practice Address - Zip Code:29676-4516
Practice Address - Country:US
Practice Address - Phone:864-944-5146
Practice Address - Fax:864-944-5147
Is Sole Proprietor?:No
Enumeration Date:2011-08-03
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6444225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist