Provider Demographics
NPI:1245637420
Name:MISKUF, AMY (PT)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:MISKUF
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 1:621 S SUGAR ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47220-2066
Mailing Address - Country:US
Mailing Address - Phone:812-358-6915
Mailing Address - Fax:812-358-5875
Practice Address - Street 1:621 S SUGAR ST
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN
Practice Address - State:IN
Practice Address - Zip Code:47220-2066
Practice Address - Country:US
Practice Address - Phone:812-358-6915
Practice Address - Fax:812-358-5875
Is Sole Proprietor?:No
Enumeration Date:2014-12-03
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05006677225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist