Provider Demographics
NPI:1609090695
Name:GREENER, AMY MARIE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:MARIE
Last Name:GREENER
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 ALPINE ST
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-6410
Mailing Address - Country:US
Mailing Address - Phone:563-213-8423
Mailing Address - Fax:
Practice Address - Street 1:2000 PASADENA DR
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-0808
Practice Address - Country:US
Practice Address - Phone:563-557-1076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03510174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist