Amanda Zynda
Individual provider Active NPI Physical Therapy Assistant · Aniwa, WI
NPI 1780951137 · NPPES record last updated Jul 6, 2016
Key facts
- NPI
- 1780951137
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 1687-19 (WI)
- Practice address
- E18121 Church Rd
Aniwa, WI 54408-9631 - Phone
- (715) 219-1522
- NPI assigned
- Nov 29, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1687-19 | WI | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 1687-19 | WI | Yes |
Addresses
Primary practice location
E18121 Church Rd
Aniwa, WI 54408-9631
Mailing address
E18121 Church Rd
Aniwa, WI 54408-9631
Other providers in Aniwa, WI
All providers in Aniwa, WI · Physical Therapy Assistant in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.