Provider Demographics
NPI:1134453228
Name:RIEL, AMY BARBARA (PT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:BARBARA
Last Name:RIEL
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:PO BOX 866308
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75086-6308
Mailing Address - Country:US
Mailing Address - Phone:800-793-5464
Mailing Address - Fax:267-321-1298
Practice Address - Street 1:860 ROUTE 134
Practice Address - Street 2:
Practice Address - City:SOUTH DENNIS
Practice Address - State:MA
Practice Address - Zip Code:02660-2577
Practice Address - Country:US
Practice Address - Phone:508-385-4212
Practice Address - Fax:508-385-4235
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17891225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist