Provider Demographics
NPI:1528095221
Name:AMIGH, VINCENT (ATC)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:
Last Name:AMIGH
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MEADOW RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SHIPPENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17257-9010
Mailing Address - Country:US
Mailing Address - Phone:717-372-7082
Mailing Address - Fax:
Practice Address - Street 1:8 MEADOW RIDGE DR
Practice Address - Street 2:
Practice Address - City:SHIPPENSBURG
Practice Address - State:PA
Practice Address - Zip Code:17257-9010
Practice Address - Country:US
Practice Address - Phone:717-372-7082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART-002318-A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer