Individual
MRS. AMY A ROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1179
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5842190
—
SD
Enumeration date
12/06/2005
Last updated
11/24/2015
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