Provider Demographics
NPI:1073736518
Name:MCFADDEN-DECKER, AMY MARIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MARIE
Last Name:MCFADDEN-DECKER
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 1:5531 N DUTCH HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:POTOSI
Mailing Address - State:WI
Mailing Address - Zip Code:53820-8805
Mailing Address - Country:US
Mailing Address - Phone:563-590-4746
Mailing Address - Fax:
Practice Address - Street 1:444 N GRANDVIEW AVE
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-6331
Practice Address - Country:US
Practice Address - Phone:563-589-2497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03656225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist