Provider Demographics
NPI:1043330780
Name:SORACE, AMY LYNN (PT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:SORACE
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 1:3721 S SAUCON AVE
Mailing Address - Street 2:
Mailing Address - City:CENTER VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18034-9459
Mailing Address - Country:US
Mailing Address - Phone:215-715-0685
Mailing Address - Fax:
Practice Address - Street 1:1200 SPRING ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-4940
Practice Address - Country:US
Practice Address - Phone:610-865-5595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015285225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist