Provider Demographics
NPI:1750494399
Name:FLESHMAN, AMY M (PT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:M
Last Name:FLESHMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 E PATTERSON ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-4002
Mailing Address - Country:US
Mailing Address - Phone:660-665-5333
Mailing Address - Fax:660-665-5332
Practice Address - Street 1:1108 E PATTERSON ST
Practice Address - Street 2:SUITE 6
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-4002
Practice Address - Country:US
Practice Address - Phone:660-665-5333
Practice Address - Fax:660-665-5332
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO02255225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO170596OtherBCBS
MS462216OtherHEALTHLINK
MO487853517Medicaid
MO487853517Medicaid