Provider Demographics
NPI:1083844229
Name:CAIN, AMANDA MARIE (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:MARIE
Last Name:CAIN
Suffix:
Gender:
Credentials:PHYSICAL THERAPIST
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:MARIE
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21636 MIDLAND DR
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66218-9064
Mailing Address - Country:US
Mailing Address - Phone:702-810-6378
Mailing Address - Fax:
Practice Address - Street 1:21636 MIDLAND DR
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66218-9064
Practice Address - Country:US
Practice Address - Phone:702-568-0195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2350225100000X
KS11-04552225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist