Provider Demographics
NPI:1013986819
Name:SPIRES, AMY E (PT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:E
Last Name:SPIRES
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 1:1221 COBB LN
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47462-5275
Mailing Address - Country:US
Mailing Address - Phone:812-278-9349
Mailing Address - Fax:812-276-1281
Practice Address - Street 1:1600 23RD ST
Practice Address - Street 2:PHYSICAL THERAPY DEPARTMENT
Practice Address - City:BEDFORD
Practice Address - State:IN
Practice Address - Zip Code:47421-4704
Practice Address - Country:US
Practice Address - Phone:812-276-1282
Practice Address - Fax:812-276-1281
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05007294A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist