Healthcare Provider Details

I. General information

NPI: 1780049676
Provider Name (Legal Business Name): AMY M DAIL PT, DPT, CKTP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2015
Last Update Date: 10/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 MARKET PLACE CIR STE D
GEORGETOWN KY
40324-7401
US

IV. Provider business mailing address

800 CRESCENT CENTRE DR STE 300
FRANKLIN TN
37067-7285
US

V. Phone/Fax

Practice location:
  • Phone: 859-300-1335
  • Fax: 859-310-7190
Mailing address:
  • Phone: 615-373-1350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number006086
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: