Provider Demographics
NPI:1598922213
Name:GURNEY, AMY LYNN (PTA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:GURNEY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 CUMBERLAND ST
Mailing Address - Street 2:APT 2
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-4016
Mailing Address - Country:US
Mailing Address - Phone:207-649-2343
Mailing Address - Fax:
Practice Address - Street 1:7 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-5309
Practice Address - Country:US
Practice Address - Phone:207-873-0705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA1742225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant