Provider Demographics
NPI:1679966436
Name:BOND, AMANDA RENEE
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:RENEE
Last Name:BOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5005 LOSEE RD APT 3091
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-2511
Mailing Address - Country:US
Mailing Address - Phone:309-540-9008
Mailing Address - Fax:
Practice Address - Street 1:5005 LOSEE RD APT 3091
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-2511
Practice Address - Country:US
Practice Address - Phone:309-540-9008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner