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NPI Code Detail

MEDICARE: MRS. AMY L STANKAVAGE MPT, ATC

MEDICARE: MRS. AMY L STANKAVAGE MPT, ATC
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
1225100000XPhysical TherapistPT016060PA
22255A2300XAthletic TrainerRT002218APA

General Provider Information

NPI Number : 1780703694
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMY L STANKAVAGE MPT, ATC
Provider Business Mailing Address
First Line : 266 LOUISA AVENUE
Second Line :
City : POTTSVILLE
State : PA
Zip : 17901
Country : US
Telephone Number : 570-429-1394
Fax Number :
Provider Business Practice Location Address
First Line : 1000 SETON DR
Second Line :
City : ORWIGSBURG
State : PA
Zip : 17961-1009
Country : US
Telephone Number : 570-366-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2007
Last Update Date : 09/11/2025

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