Provider Demographics
NPI:1689671661
Name:HERR, AMY M (PT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:M
Last Name:HERR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:471 KLUTEY PARK PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420-3347
Mailing Address - Country:US
Mailing Address - Phone:270-830-8032
Mailing Address - Fax:270-830-8132
Practice Address - Street 1:471 KLUTEY PARK PLAZA DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-3347
Practice Address - Country:US
Practice Address - Phone:270-830-8032
Practice Address - Fax:270-830-8132
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0031932251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYS90974Medicare UPIN
KY1581604Medicare ID - Type UnspecifiedADMINASTAR FEDERAL