Provider Demographics
NPI:1427485218
Name:HENDERSON, AMY M (CPTA)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:M
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:CPTA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:631 E CRAWFORD ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-5113
Mailing Address - Country:US
Mailing Address - Phone:785-825-2323
Mailing Address - Fax:785-825-2325
Practice Address - Street 1:631 E CRAWFORD ST
Practice Address - Street 2:SUITE 220
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-5113
Practice Address - Country:US
Practice Address - Phone:785-825-2323
Practice Address - Fax:785-825-2325
Is Sole Proprietor?:No
Enumeration Date:2013-10-11
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS1400996225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS223881594OtherTIN