Individual
AMY WEDGE
Active
Individual
AMY WEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, NCS, CBIS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P18746
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780234187
—
NC
01
—
205RV
BCBS OF NC
NC
01
—
Q65714A
MEDICARE
NC
Enumeration date
09/17/2019
Last updated
03/12/2024
Update your record
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