Provider Demographics
NPI:1033164355
Name:WINCHELL, AMY (PT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:WINCHELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6210 ANTLER HILL DR
Mailing Address - Street 2:
Mailing Address - City:TRAFFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15085-2310
Mailing Address - Country:US
Mailing Address - Phone:412-373-4051
Mailing Address - Fax:
Practice Address - Street 1:905 E PITTSBURGH ST
Practice Address - Street 2:SUITE E
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-3503
Practice Address - Country:US
Practice Address - Phone:724-836-3116
Practice Address - Fax:724-836-3878
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0018442251N0400X
PAPT001844E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01622266Medicaid