Provider Demographics
NPI:1659597110
Name:BARAM, AMY BETH (MSPT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:BETH
Last Name:BARAM
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 WATERGLEN LN
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-6954
Mailing Address - Country:US
Mailing Address - Phone:610-793-2519
Mailing Address - Fax:
Practice Address - Street 1:1707 WATERGLEN LN
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-6954
Practice Address - Country:US
Practice Address - Phone:610-793-2519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT011353L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist