Provider Demographics
NPI:1861843252
Name:BROWER, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:BROWER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 KLOCK RD
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13452-4517
Mailing Address - Country:US
Mailing Address - Phone:703-501-9411
Mailing Address - Fax:
Practice Address - Street 1:156 BERRY ROAD
Practice Address - Street 2:
Practice Address - City:MAYFIELD
Practice Address - State:NY
Practice Address - Zip Code:12117
Practice Address - Country:US
Practice Address - Phone:518-817-3004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-27
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA291045225100000X
MAPTL26433225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist