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NPI Code Detail

MEDICARE: AMY CLAY PTA

MEDICARE: AMY CLAY PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant09151OH

General Provider Information

NPI Number : 1063903342
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY CLAY PTA
Provider Business Mailing Address
First Line : 200 S WATER ST
Second Line :
City : FORT JENNINGS
State : OH
Zip : 45844-9368
Country : US
Telephone Number : 419-615-3694
Fax Number : 419-615-3694
Provider Business Practice Location Address
First Line : 800 AMBROSE DR
Second Line :
City : DELPHOS
State : OH
Zip : 45833-9146
Country : US
Telephone Number : 419-692-0590
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2018
Last Update Date : 05/23/2018

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Directions to “ AMY CLAY PTA” Practice Location

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