Provider Demographics
NPI:1679081392
Name:FICK, AMY (DPT, PT)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:FICK
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT, PT
Mailing Address - Street 1:4602 CUMBERLAND RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-2412
Mailing Address - Country:US
Mailing Address - Phone:910-423-5622
Mailing Address - Fax:910-378-1755
Practice Address - Street 1:1555 CAIN RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-3078
Practice Address - Country:US
Practice Address - Phone:910-423-5622
Practice Address - Fax:910-378-1755
Is Sole Proprietor?:No
Enumeration Date:2018-01-16
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP20751225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty