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NPI Code Detail

MEDICARE: AMY FIEST PT

MEDICARE: AMY FIEST PT
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
12251P0200XPediatric Physical TherapistPT004588GA
2225100000XPhysical TherapistPT004588GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110037583OTHERGAAMERIGROUP
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3344061OTHERGAWELLCARE

General Provider Information

NPI Number : 1669478756
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY FIEST PT
Provider Business Mailing Address
First Line : 1114 S WALL ST
Second Line :
City : CALHOUN
State : GA
Zip : 30701-3062
Country : US
Telephone Number : 706-624-3000
Fax Number : 706-624-3000
Provider Business Practice Location Address
First Line : 1114 S WALL ST
Second Line :
City : CALHOUN
State : GA
Zip : 30701-3062
Country : US
Telephone Number : 706-624-3000
Fax Number : 706-624-3000
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 12/19/2023

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