MEDICARE: AMY BETH BARAM MSPT

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	PT011353L	PA

General Provider Information

NPI Number	:	1659597110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY BETH BARAM MSPT

Provider Business Mailing Address
First Line	:	1707 WATERGLEN LN
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19382-6954
Country	:	US
Telephone Number	:	610-793-2519
Fax Number	:

Provider Business Practice Location Address
First Line	:	1707 WATERGLEN LN
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19382-6954
Country	:	US
Telephone Number	:	610-793-2519
Fax Number	:

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

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	07/08/2007

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