Provider Demographics
NPI:1386862209
Name:CHOTO, AMY SUSAN (PT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:SUSAN
Last Name:CHOTO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1930
Mailing Address - Street 2:
Mailing Address - City:LECANTO
Mailing Address - State:FL
Mailing Address - Zip Code:34460-1930
Mailing Address - Country:US
Mailing Address - Phone:352-613-0215
Mailing Address - Fax:
Practice Address - Street 1:1750 W MANSFIELD ST
Practice Address - Street 2:
Practice Address - City:LECANTO
Practice Address - State:FL
Practice Address - Zip Code:34461-8923
Practice Address - Country:US
Practice Address - Phone:352-613-0215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT0003620225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist