Provider Demographics
NPI:1477858033
Name:WERNER, AMY LYNN (PT, DPT)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:LYNN
Last Name:WERNER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:VAN DYK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1014 N NOLAN RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-7935
Mailing Address - Country:US
Mailing Address - Phone:817-641-8617
Mailing Address - Fax:817-645-6966
Practice Address - Street 1:1014 N NOLAN RIVER RD
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-7935
Practice Address - Country:US
Practice Address - Phone:817-641-8617
Practice Address - Fax:817-645-6966
Is Sole Proprietor?:No
Enumeration Date:2011-01-12
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1202788225100000X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic