Healthcare Provider Details

I. General information

NPI: 1073268652
Provider Name (Legal Business Name): AMY ELIZABETH LAWALL DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2022
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2933 MCCARTHY ST
SCRANTON PA
18505-3017
US

IV. Provider business mailing address

102 WOODLAND DR
JEFFERSON TOWNSHIP PA
18436-3356
US

V. Phone/Fax

Practice location:
  • Phone: 570-341-6676
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number28321
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: