Provencal, Amy

Provencal, Amy is an individual health care provider with primary practice located at 950 Campbell Ave , West Haven CT 06516-2770. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Provencal, Amy can be contacted via phone (203) 935-5711.

Contact Information

Primary practice address
950 Campbell Ave West Haven CT 06516-2770
Phone: (203) 935-5711
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 000199 Connecticut

Profile Details

NPI number 1255584561
LBN Legal business name Provencal, Amy
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 30th, 2008
Last updated Oct 30th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255584561 NPPES
Connecticut Other 22520000X PHYSICAL THERAPY ASSISTANT

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