Provider Demographics
NPI:1770828766
Name:AMBURGEY, MARY WHITNEY (PT)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:WHITNEY
Last Name:AMBURGEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:WHITNEY
Other - Last Name:MEEHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:210 BLACK GOLD BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-2620
Mailing Address - Country:US
Mailing Address - Phone:606-487-7390
Mailing Address - Fax:606-439-6987
Practice Address - Street 1:5000 KY-321
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653
Practice Address - Country:US
Practice Address - Phone:606-886-8511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-03
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist