Provider Demographics
NPI:1780322032
Name:TRESSEL, AMANDA ANNE (DPT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:ANNE
Last Name:TRESSEL
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 1:110 ARAPAHOE DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-5696
Mailing Address - Country:US
Mailing Address - Phone:319-383-3215
Mailing Address - Fax:
Practice Address - Street 1:3998 WESTDALE PRKWAY SW
Practice Address - Street 2:SUITE 300
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404
Practice Address - Country:US
Practice Address - Phone:319-396-0222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA112567225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist