Provider Demographics
NPI:1154302362
Name:LABELLE, AMY ELIZABETH (ATC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ELIZABETH
Last Name:LABELLE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:ELIZABETH
Other - Last Name:DOVERSPIKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:7553 LUBER LN
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-8479
Mailing Address - Country:US
Mailing Address - Phone:715-282-6424
Mailing Address - Fax:
Practice Address - Street 1:1903 LINCOLN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-3674
Practice Address - Country:US
Practice Address - Phone:715-369-1001
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7250392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer