Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PT007583 | PA |
NPI | 1730127549 |
---|---|
Provider Name | Amy O'shea |
First Address | Delmont, PA 15626-1005 |
Second Address | Greensburg, PA 15601-3503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1622300 | (05) | PA |