Provider Demographics
NPI:1326087214
Name:KLAIBER, AMY LYNN (PT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:KLAIBER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:DICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:22802 BENNETTS VALLEY HWY
Mailing Address - Street 2:
Mailing Address - City:WEEDVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15868-2304
Mailing Address - Country:US
Mailing Address - Phone:814-787-7657
Mailing Address - Fax:
Practice Address - Street 1:433 MAIN ST
Practice Address - Street 2:
Practice Address - City:BROCKWAY
Practice Address - State:PA
Practice Address - Zip Code:15824-1337
Practice Address - Country:US
Practice Address - Phone:814-265-8508
Practice Address - Fax:814-265-8158
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012923L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist