Provider Demographics
NPI:1245259928
Name:HOWARD, AMY M (PT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:M
Last Name:HOWARD
Suffix:
Gender:F
Credentials:PT
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Mailing Address - Street 1:90 JACKSON PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1560
Mailing Address - Country:US
Mailing Address - Phone:740-589-8805
Mailing Address - Fax:740-589-8855
Practice Address - Street 1:2131 EAST STATE STREET
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-1334
Practice Address - Country:US
Practice Address - Phone:740-589-3100
Practice Address - Fax:740-589-3123
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2014-08-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH006271225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV7304037000Medicaid
000000217253OtherANTHEM BCBS
OH2229494Medicaid
650019955OtherRR MEDICARE
OH000000204527OtherOHIO MEDICAID UNISOURCE
OH2229494OtherMOLINA MEDICAID
OH000000204527OtherOHIO MEDICAID UNISOURCE