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General NPI Number Information
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NPI Number | 1598922213
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Entity Type | Individual
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Provider Name | AMY LYNN GURNEY PTA
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Gender | Female
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 7 HIGHLAND AVE
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City | WATERVILLE
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State | ME
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Zip | 04901-5309
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Country | US
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Telephone | 207-873-0705
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Fax |
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Provider Business Mailing Address
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Address Line | 27 CUMBERLAND ST APT 2
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City | AUGUSTA
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State | ME
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Zip | 04330-4016
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Country | US
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Telephone | 207-649-2343
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PA1742
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License Number State | ME
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