Provider Demographics
NPI:1598937336
Name:REED, AMY LOU (PTA)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LOU
Last Name:REED
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LOU
Other - Last Name:STEIGELMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 S WEBSTER AVE
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-3503
Mailing Address - Country:US
Mailing Address - Phone:920-432-3213
Mailing Address - Fax:920-432-0614
Practice Address - Street 1:600 S WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-3503
Practice Address - Country:US
Practice Address - Phone:920-432-3213
Practice Address - Fax:920-432-0614
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI341-19225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40271400Medicaid