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Organization
AMG ENTERPRISES, INC
Active
Organization
AMG ENTERPRISES, INC
Active
Other names
Shine Pediatric Therapy Corning
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER GIFFORD MCD CCC/SLP (PRESIDENT)
(870) 926-5420
Entity
Organization
Contact information
Practice address
600 W ELM ST, CORNING, AR 72422-2722
(870) 926-5420
(870) 634-2009
Mailing address
801 SW 9TH ST, CORNING, AR 72422-3126
(870) 926-5420
(870) 634-2009
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154764721
—
AR
05
—
205322742
—
AR
Enumeration date
01/15/2015
Last updated
10/01/2024
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