Individual
AMY FIEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1114 S WALL ST, CALHOUN, GA 30701-3062
(706) 624-3000
(706) 624-3000
Mailing address
1114 S WALL ST, CALHOUN, GA 30701-3062
(706) 624-3000
(706) 624-3000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT004588
GA
2251P0200X
Pediatric Physical Therapist
PT004588
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000874475C
—
GA
01
—
10037583
AMERIGROUP
GA
01
—
344061
WELLCARE
GA
Enumeration date
06/22/2005
Last updated
12/19/2023
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