Provider Demographics
NPI:1750563359
Name:MCLAURIN, AMY FELTNER (PT, ATP)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:FELTNER
Last Name:MCLAURIN
Suffix:
Gender:F
Credentials:PT, ATP
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:ELAINE
Other - Last Name:FELTNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, ATP
Mailing Address - Street 1:139 MAPLE ROW BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-4487
Mailing Address - Country:US
Mailing Address - Phone:615-826-7113
Mailing Address - Fax:615-826-7139
Practice Address - Street 1:139 MAPLE ROW BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-4487
Practice Address - Country:US
Practice Address - Phone:615-826-7113
Practice Address - Fax:615-826-7139
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45202251P0200X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN12617722OtherCAQH
TNQ003948Medicaid