Provider Demographics
NPI:1558667295
Name:MINTMIER, AMY MAE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MAE
Last Name:MINTMIER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:3771 PETERS MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:HALIFAX
Mailing Address - State:PA
Mailing Address - Zip Code:17032-8605
Mailing Address - Country:US
Mailing Address - Phone:717-896-7612
Mailing Address - Fax:717-896-7617
Practice Address - Street 1:3771 PETERS MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:HALIFAX
Practice Address - State:PA
Practice Address - Zip Code:17032-8605
Practice Address - Country:US
Practice Address - Phone:717-896-7612
Practice Address - Fax:717-896-7617
Is Sole Proprietor?:No
Enumeration Date:2011-01-27
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE007053225200000X
PAPT021628225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant