Provider Demographics
NPI:1306374962
Name:AMAYA, ALEX MICHAEL (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:MICHAEL
Last Name:AMAYA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2704 BOYER ST
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-6606
Mailing Address - Country:US
Mailing Address - Phone:843-271-2423
Mailing Address - Fax:
Practice Address - Street 1:254 RED CEDAR ST
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-8967
Practice Address - Country:US
Practice Address - Phone:843-815-6999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-26
Last Update Date:2017-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics