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General NPI Number Information
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NPI Number | 1821612219
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Entity Type | Organization
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Legal Business Name | ERGO AMY PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 06/02/2020
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Last Update Date | 07/02/2020
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Provider Practice Location Address
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Address Line | 73 BARRENS CHURCH RD
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City | DILLSBURG
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State | PA
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Zip | 17019-8614
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Country | US
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Telephone | 717-576-5450
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Fax |
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Provider Business Mailing Address
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Address Line | 73 BARRENS CHURCH RD
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City | DILLSBURG
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State | PA
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Zip | 17019-8614
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Country | US
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Telephone | 717-576-5450
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMY COULON
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Credential | PT, DPT, ATP
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Telephone | 717-576-5450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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