Provider Demographics
NPI:1043825268
Name:KOELPER, AMY (PT, DPT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:KOELPER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:POYNTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10412 ALLISONVILLE RD STE 117
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2035
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10412 ALLISONVILLE RD STE 117
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2035
Practice Address - Country:US
Practice Address - Phone:260-446-9145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501302207225100000X
IN05013928A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist