Provider Demographics
NPI:1992949176
Name:GREENWELL, AMY E (OTR)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:E
Last Name:GREENWELL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:E
Other - Last Name:GETTINGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR
Mailing Address - Street 1:317 MARSHALL DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-3429
Mailing Address - Country:US
Mailing Address - Phone:502-742-3446
Mailing Address - Fax:317-818-0720
Practice Address - Street 1:9190 PRIORITY WAY WEST DR STE 110
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-1437
Practice Address - Country:US
Practice Address - Phone:317-805-4963
Practice Address - Fax:317-818-0720
Is Sole Proprietor?:No
Enumeration Date:2009-05-01
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31004230A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist