MEDICARE: AMY M OSBORN 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	11-03820	KS

General Provider Information

NPI Number	:	1427316645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY M OSBORN DPT

Provider Business Mailing Address
First Line	:	426 MCCALL RD
Second Line	:
City	:	MANHATTAN
State	:	KS
Zip	:	66502-5032
Country	:	US
Telephone Number	:	785-776-0670
Fax Number	:	785-776-0096

Provider Business Practice Location Address
First Line	:	4201B ANDERSON AVE STE 1A
Second Line	:
City	:	MANHATTAN
State	:	KS
Zip	:	66503-7601
Country	:	US
Telephone Number	:	785-539-5555
Fax Number	:	785-539-4551

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

Provider Enumeration Date	:	04/25/2012
Last Update Date	:	04/25/2012

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