Provider Demographics
NPI:1386886919
Name:NOVOTNY, AMY MARIE (DPT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:NOVOTNY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
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Mailing Address - Street 1:4858 E BASELINE RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4638
Mailing Address - Country:US
Mailing Address - Phone:480-807-6500
Mailing Address - Fax:480-897-2700
Practice Address - Street 1:725 S. DOBSON RD
Practice Address - Street 2:SUITE 203
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5679
Practice Address - Country:US
Practice Address - Phone:480-807-6500
Practice Address - Fax:480-897-2700
Is Sole Proprietor?:No
Enumeration Date:2009-03-27
Last Update Date:2014-11-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ8448225100000X
2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic