Basic Information
| Provider Information | |||||||||
| NPI: | 1255419693 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DOWNEY | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | |||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1751 VETERANS DR STE 300 | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 356304930 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567649304 | ||||||||
| FaxNumber: | 2567649343 | ||||||||
| Practice Location | |||||||||
| Address1: | 1751 VETERANS DR STE 300 | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 356304930 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567649304 | ||||||||
| FaxNumber: | 2563310054 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2006 | ||||||||
| LastUpdateDate: | 09/16/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251X0800X | 5116 | SC | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic | 225100000X | PTH6024 | AL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 529917620 | 05 | AL | MEDICAID | 5116 | 01 | SC | PT LICENSE # | OTHER | 1003819608 | 01 | AL | GROUP NPI | OTHER | 861168971 | 01 | SC | EMPLOYER ID# | OTHER |