Provider Demographics
NPI:1356653901
Name:JAMES, AMY BETH (LPTA)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:BETH
Last Name:JAMES
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:BETH
Other - Last Name:WARYAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:1032 S LINDEN RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3458
Mailing Address - Country:US
Mailing Address - Phone:810-733-3833
Mailing Address - Fax:810-733-1072
Practice Address - Street 1:1032 S LINDEN RD
Practice Address - Street 2:SUITE A
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3458
Practice Address - Country:US
Practice Address - Phone:810-733-3833
Practice Address - Fax:810-733-1072
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502000998225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant