Provider Demographics
NPI:1184887564
Name:MARSHALL, AMY LYNN (PT)
Entity type:Individual
Prefix:MR
First Name:AMY
Middle Name:LYNN
Last Name:MARSHALL
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 1:200 LEAKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LURAY
Mailing Address - State:VA
Mailing Address - Zip Code:22835-5301
Mailing Address - Country:US
Mailing Address - Phone:540-743-0502
Mailing Address - Fax:
Practice Address - Street 1:1481 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22802-2433
Practice Address - Country:US
Practice Address - Phone:540-438-4228
Practice Address - Fax:540-438-4273
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305004203225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist