Amy Deverna
Individual provider Active NPI Physical Therapy Assistant · Genoa, OH
NPI 1386060085 · NPPES record last updated Mar 5, 2014
Key facts
- NPI
- 1386060085
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- PTA-3125 (OH)
- Practice address
- 3993 Edinburgh CT
Genoa, OH 43430-9602 - Phone
- (419) 250-4132
- NPI assigned
- Mar 5, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA-3125 | OH | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA-3125 | OH | Yes |
Addresses
Primary practice location
3993 Edinburgh CT
Genoa, OH 43430-9602
Mailing address
3993 Edinburgh CT
Genoa, OH 43430-9602
Other providers in Genoa, OH
- Allen Clay Joint Fire District
- Sara Marie Barr
- Bree Ann Bauerschmidt
- Elizabeth Bergman
- Kelsey Buckley
- Debra S Dibert
- Aubrey Diebert
- Jennifer Dirnberg
- Linda Lou Fiore
- Anna Renee Fretz
All providers in Genoa, OH · Physical Therapy Assistant in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.