Individual
AMANDA C LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
106 NW 112TH ST, KANSAS CITY, MO 64155-3615
(816) 519-3310
Mailing address
106 NW 112TH ST, KANSAS CITY, MO 64155-3615
(816) 519-3310
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2021015424
MO
Other
Enumeration date
05/28/2021
Last updated
05/28/2021
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