Provider Demographics
NPI:1083849939
Name:GASSMANN, AMY LYNN (PT)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LYNN
Last Name:GASSMANN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:GASSMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 38
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:IA
Mailing Address - Zip Code:52042-0038
Mailing Address - Country:US
Mailing Address - Phone:563-928-7170
Mailing Address - Fax:563-928-7185
Practice Address - Street 1:104 W. UNION ST.
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:IA
Practice Address - Zip Code:52042
Practice Address - Country:US
Practice Address - Phone:563-928-7170
Practice Address - Fax:563-928-7185
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02946225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist