Provider Demographics
NPI:1841420601
Name:MCMANUS, AMY J (DPT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:J
Last Name:MCMANUS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 THORNTON AVE
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-2891
Mailing Address - Country:US
Mailing Address - Phone:207-294-8448
Mailing Address - Fax:207-282-2122
Practice Address - Street 1:12 THORNTON AVE
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-2891
Practice Address - Country:US
Practice Address - Phone:072-294-8448
Practice Address - Fax:207-282-2122
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT3544225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME001229204Medicare PIN