Provider Demographics
NPI:1770890998
Name:DICHTER, AMANDA KATE (DPT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:KATE
Last Name:DICHTER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:REIFLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7205 ESTERO BLVD UNIT 5
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33931-4786
Mailing Address - Country:US
Mailing Address - Phone:239-314-5118
Mailing Address - Fax:239-314-5119
Practice Address - Street 1:7205 ESTERO BLVD UNIT 5
Practice Address - Street 2:
Practice Address - City:FORT MYERS BEACH
Practice Address - State:FL
Practice Address - Zip Code:33931-4786
Practice Address - Country:US
Practice Address - Phone:239-314-5118
Practice Address - Fax:239-314-5119
Is Sole Proprietor?:No
Enumeration Date:2010-09-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01364700225100000X
FLPT32747225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist