Keaster, Amanda Ellisha
Keaster, Amanda Ellisha is an sole proprietor health care provider with primary practice located at 920 University Dr , Russellville AR 72801-4303. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Keaster, Amanda Ellisha can be contacted via phone (479) 967-2322.Contact Information
Primary practice address
920 University Dr
Russellville AR 72801-4303
Phone: (479) 967-2322
Fax: (479) 967-2876
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | OTR2066 | Arkansas |
Profile Details
| NPI number | 1184732752 |
|---|---|
| LBN Legal business name | Keaster, Amanda Ellisha |
| Credentials | OTR/L |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 25th, 2006 |
| Last updated | Jul 21st, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184732752 | NPPES |
| Arkansas | Other | 662725 | HEALTHLINK |
| Arkansas | MEDICAID | 162765721 | HEALTHLINK |
| Arkansas | Other | 5A030 | HEALTHLINK |
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