Provider Demographics
NPI:1053528729
Name:DADY, AMANDA ANN (PT)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:ANN
Last Name:DADY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22408 LAIKA AVE
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-4727
Mailing Address - Country:US
Mailing Address - Phone:941-743-3222
Mailing Address - Fax:
Practice Address - Street 1:716 POPLAR ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2546
Practice Address - Country:US
Practice Address - Phone:270-762-1854
Practice Address - Fax:270-762-1856
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY005091225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist