MEDICARE: AMY COMER LPTA

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	225200000X	Physical Therapy Assistant	2306601824	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2306601824	OTHER	VA	VIRGINIA BOARD OF PHYSICAL THERAPY

General Provider Information

NPI Number	:	1821682287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY COMER LPTA

Provider Business Mailing Address
First Line	:	1191 HIGH ROCK TRL
Second Line	:
City	:	VERNON HILL
State	:	VA
Zip	:	24597-3226
Country	:	US
Telephone Number	:	434-470-6141
Fax Number	:

Provider Business Practice Location Address
First Line	:	1191 HIGH ROCK TRL
Second Line	:
City	:	VERNON HILL
State	:	VA
Zip	:	24597-3226
Country	:	US
Telephone Number	:	434-470-6141
Fax Number	:

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

Provider Enumeration Date	:	02/25/2021
Last Update Date	:	02/25/2021

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Directions to “ AMY COMER LPTA” Practice Location

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