Provider Demographics
NPI:1952575805
Name:OWENS, AMY LYNN (PTA, LMT)
Entity Type:Individual
Prefix:MISS
First Name:AMY
Middle Name:LYNN
Last Name:OWENS
Suffix:
Gender:F
Credentials:PTA, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:273 PENINSULA FARM RD
Mailing Address - Street 2:BUIDLING 2 SUITE C
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-1012
Mailing Address - Country:US
Mailing Address - Phone:410-975-5343
Mailing Address - Fax:
Practice Address - Street 1:273 PENINSULA FARM RD
Practice Address - Street 2:BUILDING 2 SUITE C
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012-1012
Practice Address - Country:US
Practice Address - Phone:410-975-5343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA2694225200000X
MDMO4549225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist