Provider Demographics
NPI:1558654863
Name:SHANK, AMIE LYNN
Entity type:Individual
Prefix:MRS
First Name:AMIE
Middle Name:LYNN
Last Name:SHANK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 PAULMARK AVE
Mailing Address - Street 2:
Mailing Address - City:GREENCASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:17225-8454
Mailing Address - Country:US
Mailing Address - Phone:717-597-5489
Mailing Address - Fax:
Practice Address - Street 1:1608 PAULMARK AVE
Practice Address - Street 2:
Practice Address - City:GREENCASTLE
Practice Address - State:PA
Practice Address - Zip Code:17225-8454
Practice Address - Country:US
Practice Address - Phone:717-597-5489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-18
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist