Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1202788 | TX |
N | 2251S0007X | Physical Therapist - Sports | 1202788 | TX |
N | 2251X0800X | Physical Therapist - Orthopedic | 1202788 | TX |
NPI | 1477858033 |
---|---|
Provider Name | Ms. Amy Lynn Werner |
First Address | Cleburne, TX 76033-7935 |
Second Address | Cleburne, TX 76033-7935 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2011 |
Last Update Date | 25/03/2011 |