Provider Demographics
NPI:1932722840
Name:SNEED, AMANDA MARIE (PT, DPT, CLT)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:MARIE
Last Name:SNEED
Suffix:
Gender:F
Credentials:PT, DPT, CLT
Other - Prefix:MISS
Other - First Name:AMANDA
Other - Middle Name:MARIE
Other - Last Name:CHURCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:858 DAKOTA AVE S
Mailing Address - Street 2:
Mailing Address - City:HURON
Mailing Address - State:SD
Mailing Address - Zip Code:57350-2814
Mailing Address - Country:US
Mailing Address - Phone:317-682-7831
Mailing Address - Fax:
Practice Address - Street 1:858 DAKOTA AVE S
Practice Address - Street 2:
Practice Address - City:HURON
Practice Address - State:SD
Practice Address - Zip Code:57350-2814
Practice Address - Country:US
Practice Address - Phone:317-682-7831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-26
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1959225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist