Individual
DR. AMANDA K KOCIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1 PINE TREE CT, KEWANEE, IL 61443-9600
(309) 540-9895
Mailing address
1051 W SOUTH ST, PO BOX 747, KEWANEE, IL 61443-8354
(309) 852-7500
(309) 852-7948
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-014532
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070-014532
IL LICENSE NO
IL
Enumeration date
10/14/2010
Last updated
06/14/2012
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