Provider Demographics
NPI:1982796843
Name:ROBINSON, AMY (PT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:438 S EMERSON AVE
Mailing Address - Street 2:SUITE 146
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1948
Mailing Address - Country:US
Mailing Address - Phone:317-410-6635
Mailing Address - Fax:
Practice Address - Street 1:438 S EMERSON AVE
Practice Address - Street 2:SUITE 146
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1948
Practice Address - Country:US
Practice Address - Phone:317-410-6635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05005032A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN38-2617193Medicare UPIN