| NPI | 1477858033 |
|---|---|
| Former Name | AMY LYNN VAN DYK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1202788) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: TX 1202788) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: TX 1202788) | |
| Enumeration Date | 2011-01-12 |
| Last Update Date | 2011-03-25 |