Provider Demographics
NPI:1225179054
Name:CASEY, AMY PIERSOL (PT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:PIERSOL
Last Name:CASEY
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 1:2209 FRANKFORT RD
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-9470
Mailing Address - Country:US
Mailing Address - Phone:859-533-7763
Mailing Address - Fax:502-499-8839
Practice Address - Street 1:1740 NICHOLASVILLE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1431
Practice Address - Country:US
Practice Address - Phone:859-260-6144
Practice Address - Fax:859-260-6430
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPT-004482225100000X
FLPT 18094225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist