Provider Demographics
NPI:1578614871
Name:HUGHES, AMY DANIELLE (PT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:DANIELLE
Last Name:HUGHES
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 1:204 OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:OK
Mailing Address - Zip Code:74016-1837
Mailing Address - Country:US
Mailing Address - Phone:918-948-5592
Mailing Address - Fax:
Practice Address - Street 1:1501 N. FLORENCE
Practice Address - Street 2:SUITE 330
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-3058
Practice Address - Country:US
Practice Address - Phone:918-342-6703
Practice Address - Fax:918-342-7889
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3925225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist