Healthcare Provider Details

I. General information

NPI: 1891750295
Provider Name (Legal Business Name): AMY ELIZABETH ALTSHULER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 05/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 CROSSROADS BLVD
CARMEL CA
93923-8650
US

IV. Provider business mailing address

245 THE CROSSROADS BLVD
CARMEL CA
93923-8650
US

V. Phone/Fax

Practice location:
  • Phone: 831-620-0744
  • Fax:
Mailing address:
  • Phone: 831-620-0744
  • Fax: 831-620-0711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number13182
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: