Basic Information
| Provider Information | |||||||||
| NPI: | 1932410818 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OSBORNE | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5393 E OSBORNE RD | ||||||||
| Address2: | |||||||||
| City: | VINCENNES | ||||||||
| State: | IN | ||||||||
| PostalCode: | 475919165 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8127432546 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1712 LELAND DR | ||||||||
| Address2: | THE WATERS OF HUNTINBURG | ||||||||
| City: | HUNTINGBURG | ||||||||
| State: | IN | ||||||||
| PostalCode: | 47542 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8126834090 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2010 | ||||||||
| LastUpdateDate: | 06/25/2010 | ||||||||
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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 | 225200000X | 06001318A | IN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.