Individual
MS. AMY SOUTHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
441 BUTLER AVENUE, LANCASTER, PA 17601-4446
(717) 397-6979
Mailing address
441 BUTLER AVE, LANCASTER, PA 17601-4446
(717) 397-6979
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
TEI000232
PA
Other
Enumeration date
04/21/2010
Last updated
04/21/2010
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