Provider Demographics
NPI:1043269111
Name:FLUG, AMY S (PT,DPT,OSC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:S
Last Name:FLUG
Suffix:
Gender:F
Credentials:PT,DPT,OSC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:S
Other - Last Name:FLUG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT,DPT,OSC
Mailing Address - Street 1:708 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:WI
Mailing Address - Zip Code:54722-9085
Mailing Address - Country:US
Mailing Address - Phone:715-286-2488
Mailing Address - Fax:715-286-2493
Practice Address - Street 1:708 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:WI
Practice Address - Zip Code:54722-9085
Practice Address - Country:US
Practice Address - Phone:715-286-2488
Practice Address - Fax:715-286-2493
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10429-24225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40453500Medicaid
WIWI3205Medicare PIN