Doctor Name: | NICOLE A AMOS |
NPI Number: | 1326112988 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 070.016637 |
Business Practice Address: | 2100 Madison Ave Granite City, IL - 620404701 |
Business Phone Number: | 6197983135 |
Business Fax Number: | |
Mailing Address: | 2609 Lauren Lake Dr, BELLEVILLE |
State: | IL |
Postal Code: | 622218620 |
Phone Number: | 6189606407 |
Fax Number: | |
NPI Enumeration Date: | 11/17/2006 |
NPI Last Update Date: | 12/20/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 070.016637 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |