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General NPI Number Information
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NPI Number | 1487012969
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Entity Type | Individual
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Provider Name | AMANDA NIKIEL PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 01/29/2016
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Last Update Date | 06/25/2019
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Provider Practice Location Address
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Address Line | 929 PACIFIC STREET
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City | MONTEREY
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State | CA
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Zip | 93940-9394
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Country | US
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Telephone | 831-373-1209
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Fax |
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Provider Business Mailing Address
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Address Line | 8250 COLONIAL DR
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City | NIAGARA FALLS
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State | NY
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Zip | 14304-1058
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Country | US
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Telephone | 716-807-2282
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 291564
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License Number State | CA
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