Provider Demographics
NPI:1083699185
Name:ADAMCZYK, AMY (CPO)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:ADAMCZYK
Suffix:
Gender:F
Credentials:CPO
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CPO
Mailing Address - Street 1:6490 S. MCCARRAN BLVD.
Mailing Address - Street 2:SUITE D-38
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6125
Mailing Address - Country:US
Mailing Address - Phone:775-823-9669
Mailing Address - Fax:775-823-9931
Practice Address - Street 1:6490 S. MCCARRAN BLVD.
Practice Address - Street 2:SUITE D-38
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6125
Practice Address - Country:US
Practice Address - Phone:775-823-9669
Practice Address - Fax:775-823-9931
Is Sole Proprietor?:No
Enumeration Date:2005-12-12
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACPO2108OtherPROFESSIONAL CERTIFICATE