Provider Demographics
NPI:1841463502
Name:SHAH, AMI F (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:AMI
Middle Name:F
Last Name:SHAH
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:679 CORNELL DR
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-4414
Mailing Address - Country:US
Mailing Address - Phone:216-849-1982
Mailing Address - Fax:
Practice Address - Street 1:679 CORNELL DR
Practice Address - Street 2:
Practice Address - City:BROADVIEW HTS
Practice Address - State:OH
Practice Address - Zip Code:44147-4414
Practice Address - Country:US
Practice Address - Phone:216-849-1982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH011289225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist