Provider Demographics
NPI:1558708289
Name:KANOUR, AMY KAY
Entity Type:Individual
Prefix:MISS
First Name:AMY
Middle Name:KAY
Last Name:KANOUR
Suffix:
Gender:F
Credentials:
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 366550
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34136-6550
Mailing Address - Country:US
Mailing Address - Phone:866-604-2931
Mailing Address - Fax:570-524-2817
Practice Address - Street 1:41 S 3RD ST
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-1944
Practice Address - Country:US
Practice Address - Phone:866-604-2931
Practice Address - Fax:570-524-2817
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1101XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic Assistant