Provider Demographics
NPI:1952504813
Name:KARNES, AMY MICHELE (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MICHELE
Last Name:KARNES
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:MICHELE
Other - Last Name:BOWMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6850 LOWS ROAD
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815
Mailing Address - Country:US
Mailing Address - Phone:570-784-6860
Mailing Address - Fax:570-784-5326
Practice Address - Street 1:6850 LOWS ROAD
Practice Address - Street 2:
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815
Practice Address - Country:US
Practice Address - Phone:570-784-6860
Practice Address - Fax:570-784-5326
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEMPORARYTPT020448225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist