Provider Demographics
NPI:1801018189
Name:MEILEN, AMY LEE (PT)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LEE
Last Name:MEILEN
Suffix:
Gender:
Credentials:PT
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:LEE
Other - Last Name:MEILEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:10456 FOOTHILLS HWY
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-9001
Mailing Address - Country:US
Mailing Address - Phone:303-823-2320
Mailing Address - Fax:
Practice Address - Street 1:10456 FOOTHILLS HWY
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-9001
Practice Address - Country:US
Practice Address - Phone:303-823-2320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5420225100000X
NY5420225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist