Provider Demographics
NPI:1093901209
Name:LOW, AMY K (PT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:K
Last Name:LOW
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 1:1107 BRIDLE DR
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-9687
Mailing Address - Country:US
Mailing Address - Phone:509-627-2474
Mailing Address - Fax:
Practice Address - Street 1:1107 BRIDLE DR
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-9687
Practice Address - Country:US
Practice Address - Phone:509-627-2474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT601992492251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPT 60199249OtherWASHINGTON STATE DEPARTMENT OF HEALTH
HI2797OtherBOARD OF PHYSICAL THERAPY