Individual
AMY RAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
05007319A
IN
225100000X
Physical Therapist
Primary
05007319A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200443720
—
IN
Enumeration date
10/02/2006
Last updated
04/07/2023
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