MEDICARE: AMANDA MARIE MCCURRY P.T.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	2004030579	MO

General Provider Information

NPI Number	:	1639352925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA MARIE MCCURRY P.T.A.

Provider Business Mailing Address
First Line	:	27829 HIGHWAY F
Second Line	:
City	:	SAINT CATHARINE
State	:	MO
Zip	:	64628-7922
Country	:	US
Telephone Number	:	816-294-8275
Fax Number	:

Provider Business Practice Location Address
First Line	:	27829 HIGHWAY F
Second Line	:
City	:	SAINT CATHARINE
State	:	MO
Zip	:	64628-7922
Country	:	US
Telephone Number	:	816-294-8275
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2007
Last Update Date	:	12/10/2007

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