Individual
AMY JOLENE BEVACQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
11277 VERNON PL, MEADVILLE, PA 16335-3717
(814) 333-5214
(814) 333-1482
Mailing address
13542 W VERNON RD, CONNEAUT LAKE, PA 16316-6748
(814) 282-6995
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT018024
PA
Other
Enumeration date
07/23/2018
Last updated
07/23/2018
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