MEDICARE: DR. AMY FLETCHER DPT

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
1	225100000X	Physical Therapist	2996	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144260365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY FLETCHER DPT

Provider Business Mailing Address
First Line	:	312 ROSEMONT AVE NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87102-1522
Country	:	US
Telephone Number	:	505-511-4334
Fax Number	:

Provider Business Practice Location Address
First Line	:	312 ROSEMONT AVE NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87102-1522
Country	:	US
Telephone Number	:	505-577-4334
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	01/04/2019

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