Provider Demographics
NPI:1578663068
Name:CHEEVER, AMY B (PT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:B
Last Name:CHEEVER
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 1:441 WATERTOWER CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-5801
Mailing Address - Country:US
Mailing Address - Phone:802-655-7575
Mailing Address - Fax:802-655-1115
Practice Address - Street 1:441 WATERTOWER CIR
Practice Address - Street 2:SUITE 100
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-5801
Practice Address - Country:US
Practice Address - Phone:802-655-7575
Practice Address - Fax:802-655-1115
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040-0003647225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist