Individual
AMANDA LYNN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
411 W HAYCRAFT AVE # STDD1, COEUR D ALENE, ID 83815-8105
(208) 664-2468
Mailing address
4246 W SAW BLADE LN APT 102, COEUR D ALENE, ID 83814-0022
(208) 731-9528
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6569
ID
Other
Enumeration date
02/06/2020
Last updated
11/30/2023
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