Provider Demographics
NPI:1699860312
Name:MCDANIEL, AMY LEE (MS PT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LEE
Last Name:MCDANIEL
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Gender:F
Credentials:MS PT
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Mailing Address - Street 1:400 N STEWART ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:MO
Mailing Address - Zip Code:64673-1302
Mailing Address - Country:US
Mailing Address - Phone:660-748-3600
Mailing Address - Fax:660-748-3605
Practice Address - Street 1:807 HICKLAND ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:MO
Practice Address - Zip Code:64673
Practice Address - Country:US
Practice Address - Phone:660-748-3600
Practice Address - Fax:660-748-3605
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2019-10-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO117457225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist