Provider Demographics
NPI:1124274634
Name:MULHERIN, AMY J (PTA)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:J
Last Name:MULHERIN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 OAK HILL RD
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04350-3413
Mailing Address - Country:US
Mailing Address - Phone:207-268-2489
Mailing Address - Fax:
Practice Address - Street 1:5500 BROOKTREE RD.
Practice Address - Street 2:REHAB CARE, SUITE 102
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9260
Practice Address - Country:US
Practice Address - Phone:207-268-2489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-15
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA1085225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant