Provider Demographics
NPI:1881790566
Name:FARRER, AMY LYNN (DPT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:FARRER
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 1:430 INNOVATION DRIVE
Mailing Address - Street 2:
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15717-8096
Mailing Address - Country:US
Mailing Address - Phone:724-343-4060
Mailing Address - Fax:724-343-4069
Practice Address - Street 1:127 N MAIN ST
Practice Address - Street 2:NORTHERN TIER PROFESSIONAL BUILDING
Practice Address - City:MANSFIELD
Practice Address - State:PA
Practice Address - Zip Code:16933-1305
Practice Address - Country:US
Practice Address - Phone:570-662-2317
Practice Address - Fax:570-662-3269
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012698L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02998701OtherCAPITAL/KHPC
PA234755OtherHEALTH AMER/HEALTH ASSUR.
PASH402595OtherHIGHMARK BLUE SHIELD
PA402595OtherFPH/BCNE
PA02998701OtherCAPITAL/KHPC