Provider Demographics
NPI:1437378692
Name:FLICK, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:FLICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:FLICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:165 CENTENNIAL HILLS RD
Mailing Address - Street 2:
Mailing Address - City:PORT MATILDA
Mailing Address - State:PA
Mailing Address - Zip Code:16870-8312
Mailing Address - Country:US
Mailing Address - Phone:814-861-6608
Mailing Address - Fax:814-861-6610
Practice Address - Street 1:2766 W COLLEGE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-2647
Practice Address - Country:US
Practice Address - Phone:814-861-6608
Practice Address - Fax:814-861-6610
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT010739L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist