Provider Demographics
NPI:1346545001
Name:EDWARDS, AMY BETH (CPTA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:BETH
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:CPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 SE 3RD ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-3904
Mailing Address - Country:US
Mailing Address - Phone:316-283-6600
Mailing Address - Fax:316-283-6375
Practice Address - Street 1:1035 SE 3RD ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-3904
Practice Address - Country:US
Practice Address - Phone:316-283-6600
Practice Address - Fax:316-283-6375
Is Sole Proprietor?:No
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-01537225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant