Healthcare Provider Details

I. General information

NPI: 1639643679
Provider Name (Legal Business Name): ADAM AMSPACHER OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2019
Last Update Date: 01/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 COLONIAL AVE
YORK PA
17403-3430
US

IV. Provider business mailing address

3187 ZUMBRUM RD
GLENVILLE PA
17329-9378
US

V. Phone/Fax

Practice location:
  • Phone: 717-845-2661
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOC015366
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: