Provider Demographics
NPI:1407033368
Name:AMABILE, AMY HELEN (MPT)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:HELEN
Last Name:AMABILE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2521 N MAIN ST
Mailing Address - Street 2:#1-224
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-1154
Mailing Address - Country:US
Mailing Address - Phone:575-496-0801
Mailing Address - Fax:
Practice Address - Street 1:2521 N MAIN ST
Practice Address - Street 2:#1-224
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-1154
Practice Address - Country:US
Practice Address - Phone:575-496-0801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-23
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3058225100000X
NY029162-1225100000X
TX1172446225100000X
PAPT020450225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist