Provider Demographics
NPI:1225475510
Name:BETTS, AMY L (AT, MED)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:L
Last Name:BETTS
Suffix:
Gender:F
Credentials:AT, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5755 GUISS RD
Mailing Address - Street 2:
Mailing Address - City:NEW WASHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:44854-9728
Mailing Address - Country:US
Mailing Address - Phone:419-492-2601
Mailing Address - Fax:
Practice Address - Street 1:5755 GUISS RD
Practice Address - Street 2:
Practice Address - City:NEW WASHINGTON
Practice Address - State:OH
Practice Address - Zip Code:44854-9728
Practice Address - Country:US
Practice Address - Phone:419-492-2601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-28
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0018672255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer