Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | TE011550 | PA |
NPI | 1013420215 |
---|---|
Provider Name | Amy Zumpano |
First Address | West Chester, PA 19382-2149 |
Second Address | West Chester, PA 19382-2149 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2017 |
Last Update Date | 09/11/2017 |