Provider Demographics
NPI:1033349725
Name:SPEER, AMY BETH (OTR, MOT, CHT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:BETH
Last Name:SPEER
Suffix:
Gender:F
Credentials:OTR, MOT, CHT
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:BETH
Other - Last Name:BROADHURST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:6397 LEE HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2564
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:3747 SW RAINTREE DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64082-4606
Practice Address - Country:US
Practice Address - Phone:816-537-5648
Practice Address - Fax:816-537-5649
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-02618225XH1200X
MO2009019126225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOMA4370017OtherMEDICARE PTAN
42838028OtherBCBS KC
KSKA2868023OtherMEDICARE PTAN