Provider Demographics
NPI:1952700098
Name:MENZIE, AMBER FAY (PTA)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:FAY
Last Name:MENZIE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4805 LANGLEY AVE
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:OH
Mailing Address - Zip Code:43213-6125
Mailing Address - Country:US
Mailing Address - Phone:614-501-8271
Mailing Address - Fax:
Practice Address - Street 1:4805 LANGLEY AVE
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:OH
Practice Address - Zip Code:43213-6125
Practice Address - Country:US
Practice Address - Phone:614-501-8271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH08247225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant