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General NPI Number Information
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NPI Number | 1265581656
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Entity Type | Individual
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Provider Name | AMY ELIZABETH GREENWAY MSOTRL
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Gender | Female
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 20740 S ELLSWORTH RD
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City | QUEEN CREEK
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State | AZ
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Zip | 85242-9058
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Country | US
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Telephone | 480-354-2769
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Fax |
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Provider Business Mailing Address
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Address Line | 2945 S CALLE NOVENTA
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City | MESA
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State | AZ
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Zip | 85212-2807
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Country | US
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Telephone | 480-354-2769
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 3219
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License Number State | AZ
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