Provider Demographics
NPI:1386338978
Name:KOURI, AMANDA MARIE (DPT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIE
Last Name:KOURI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 W HEFNER RD STE D
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-5060
Mailing Address - Country:US
Mailing Address - Phone:405-849-9205
Mailing Address - Fax:405-400-8788
Practice Address - Street 1:3333 W HEFNER RD STE D
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-5060
Practice Address - Country:US
Practice Address - Phone:405-849-9205
Practice Address - Fax:405-400-8788
Is Sole Proprietor?:No
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6318225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist