Healthcare Provider Details

I. General information

NPI: 1366857401
Provider Name (Legal Business Name): AMY KUNDRAT PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMY BARNES PT

II. Dates (important events)

Enumeration Date: 06/27/2014
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2622 HUBBARD RD
MADISON OH
44057-2530
US

IV. Provider business mailing address

2622 HUBBARD RD
MADISON OH
44057-2530
US

V. Phone/Fax

Practice location:
  • Phone: 440-286-8511
  • Fax: 440-285-8662
Mailing address:
  • Phone: 440-286-8511
  • Fax: 440-285-8662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number012339
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: