| Doctor Name: | MS. AMY ELIZABETH FAGAN |
| NPI Number: | 1730131517 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.P.T. |
| License Number: | 2305204357 |
| Business Practice Address: | 4818 Market Square Ln Midlothian, VA - 231124826 |
| Business Phone Number: | 8047443993 |
| Business Fax Number: | 8047444301 |
| Mailing Address: | 5301 Providence Rd, Suite 80 VIRGINIA BEACH |
| State: | VA |
| Postal Code: | 234644128 |
| Phone Number: | 7574671900 |
| Fax Number: | 7574677900 |
| NPI Enumeration Date: | 05/17/2006 |
| NPI Last Update Date: | 01/07/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 2305204357 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| 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 |