Provider Demographics
NPI:1932400454
Name:KUANDART, AMANDA MARIE (PTA)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIE
Last Name:KUANDART
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5532 JFK BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-6708
Mailing Address - Country:US
Mailing Address - Phone:501-588-3211
Mailing Address - Fax:
Practice Address - Street 1:2700 BRYAN RD STE C&D
Practice Address - Street 2:
Practice Address - City:VAN BUREN
Practice Address - State:AR
Practice Address - Zip Code:72956-5059
Practice Address - Country:US
Practice Address - Phone:479-632-0590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-15
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2417225200000X
ARPTA 2417225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant