Provider Demographics
NPI:1891335527
Name:CHRISTIAN, AMANDA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6830 W HILL RD
Mailing Address - Street 2:
Mailing Address - City:DEANSBORO
Mailing Address - State:NY
Mailing Address - Zip Code:13328-1114
Mailing Address - Country:US
Mailing Address - Phone:315-794-5428
Mailing Address - Fax:
Practice Address - Street 1:HCR HOME CARE- 6007 FAIR LAKES RD
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057
Practice Address - Country:US
Practice Address - Phone:315-264-2604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy