Provider Demographics
NPI:1558528430
Name:TALCOTT, AMIE MCSWAIN (PT)
Entity Type:Individual
Prefix:MRS
First Name:AMIE
Middle Name:MCSWAIN
Last Name:TALCOTT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2311
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:GA
Mailing Address - Zip Code:31032-2311
Mailing Address - Country:US
Mailing Address - Phone:478-986-0158
Mailing Address - Fax:
Practice Address - Street 1:2249 VINSON HWY SE
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-4807
Practice Address - Country:US
Practice Address - Phone:478-453-0163
Practice Address - Fax:478-453-0164
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005375225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist