Provider Demographics
NPI:1073948832
Name:HORTON, AMY PAULETTE (PTA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:PAULETTE
Last Name:HORTON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:PAULETTE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1760 WILLIAMS HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:MC EWEN
Mailing Address - State:TN
Mailing Address - Zip Code:37101-4913
Mailing Address - Country:US
Mailing Address - Phone:615-830-2096
Mailing Address - Fax:
Practice Address - Street 1:451 HIGHWAY 13 S
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:TN
Practice Address - Zip Code:37185-2109
Practice Address - Country:US
Practice Address - Phone:931-296-5360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-11
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5286225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant