Provider Demographics
NPI:1669909792
Name:KLUVER, AMANDA M (MS, ATC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:M
Last Name:KLUVER
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:M
Other - Last Name:GOSLAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, ATC
Mailing Address - Street 1:15810 YOUNG CIR
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68007-1400
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15810 YOUNG CIR
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:NE
Practice Address - Zip Code:68007-1400
Practice Address - Country:US
Practice Address - Phone:712-263-7945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-19
Last Update Date:2017-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8422255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer