Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT015217 | PA |
NPI | 1003149675 |
---|---|
Provider Name | Amy Marie Dwyer |
First Address | West Chester, PA 19380 |
Second Address | West Chester, PA 19382 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2009 |
Last Update Date | 14/09/2009 |