Healthcare Provider Details

I. General information

NPI: 1437566908
Provider Name (Legal Business Name): AMY SHEPARD P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2014
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7645 MARKET ST STE 110
YOUNGSTOWN OH
44512-6098
US

IV. Provider business mailing address

2000 WESTINGHOUSE DR STE 200
CRANBERRY TWP PA
16066-5238
US

V. Phone/Fax

Practice location:
  • Phone: 330-965-9330
  • Fax:
Mailing address:
  • Phone: 724-343-4046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT023378
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: