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General NPI Number Information
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NPI Number | 1447141411
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Entity Type | Individual
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Provider Name | AMANDA ZILLIKEN LMT
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Gender | Female
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Dates
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Enumeration Date | 07/09/2025
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 200 W 1ST ST STE 301&302
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City | FARMINGTON
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State | MO
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Zip | 63640-2528
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Country | US
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Telephone | 636-495-5375
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Fax |
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Provider Business Mailing Address
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Address Line | 629 MAPLE VALLEY DR STE 53
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City | FARMINGTON
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State | MO
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Zip | 63640-1993
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Country | US
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Telephone | 636-258-2105
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 2025010543
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License Number State | MO
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