Provider Demographics
NPI:1184857468
Name:MATHEWSON, AMY BELL (PT)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:BELL
Last Name:MATHEWSON
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 1:400 VISION DR
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-3855
Mailing Address - Country:US
Mailing Address - Phone:336-672-5450
Mailing Address - Fax:336-672-3174
Practice Address - Street 1:400 VISION DR
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-3855
Practice Address - Country:US
Practice Address - Phone:336-672-5450
Practice Address - Fax:336-672-3174
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-02
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3248225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist