MEDICARE: MS. AMY J EASON PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2090	WV

General Provider Information

NPI Number	:	1588743074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AMY J EASON PT

Provider Business Mailing Address
First Line	:	PO BOX 976
Second Line	:
City	:	FRANKLIN
State	:	WV
Zip	:	26807-0976
Country	:	US
Telephone Number	:	304-249-6224
Fax Number	:	304-358-3494

Provider Business Practice Location Address
First Line	:	141 MAPLE AVENUE
Second Line	:
City	:	FRANKLIN
State	:	WV
Zip	:	26807-0700
Country	:	US
Telephone Number	:	304-358-2325
Fax Number	:	304-358-3494

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	12/10/2015

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