Provider Demographics
NPI:1427006303
Name:RACO, AMY MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:RACO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:MARIE
Other - Last Name:ZOELLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:9365 MCKNIGHT RD STE 300
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5901
Mailing Address - Country:US
Mailing Address - Phone:412-630-9750
Mailing Address - Fax:412-630-9761
Practice Address - Street 1:9365 MCKNIGHT RD
Practice Address - Street 2:SUITE 300
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5956
Practice Address - Country:US
Practice Address - Phone:412-630-9750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017463225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist