Provider Demographics
NPI:1891982591
Name:MCGLOTHIN, AMY D (CERTIFIED OCCUPATION)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:D
Last Name:MCGLOTHIN
Suffix:
Gender:F
Credentials:CERTIFIED OCCUPATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 VIRGINIA AVE
Mailing Address - Street 2:HEARTLAND REHABILITATION SERVICES OF VIRGINIA INC
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382
Mailing Address - Country:US
Mailing Address - Phone:276-228-6200
Mailing Address - Fax:276-228-9175
Practice Address - Street 1:342 VIRGINIA AVE
Practice Address - Street 2:HEARTLAND REHABILITATION SERVICES OF VIRGINIA INC
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382
Practice Address - Country:US
Practice Address - Phone:276-228-6200
Practice Address - Fax:276-228-9175
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
1061777224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant