Provider Demographics
NPI:1427213644
Name:TREMBACK-BALL, AMY (PHD, PT)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:TREMBACK-BALL
Suffix:
Gender:F
Credentials:PHD, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 ROSE ST
Mailing Address - Street 2:
Mailing Address - City:PECKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18452-2231
Mailing Address - Country:US
Mailing Address - Phone:570-383-7096
Mailing Address - Fax:
Practice Address - Street 1:317 ROSE ST
Practice Address - Street 2:
Practice Address - City:PECKVILLE
Practice Address - State:PA
Practice Address - Zip Code:18452-2231
Practice Address - Country:US
Practice Address - Phone:570-383-7096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-010998-L2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics