Provider Demographics
NPI:1700038296
Name:THOROUGHMAN, AMY LYKINS (PT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LYKINS
Last Name:THOROUGHMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:MICHELLE
Other - Last Name:LYKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:5006 ATWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8179
Mailing Address - Country:US
Mailing Address - Phone:859-623-2057
Mailing Address - Fax:859-623-2058
Practice Address - Street 1:5006 ATWOOD DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-8179
Practice Address - Country:US
Practice Address - Phone:859-623-2057
Practice Address - Fax:859-623-2058
Is Sole Proprietor?:No
Enumeration Date:2008-10-16
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5141225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4220815OtherBCBS OF TENNESSEE
TN0446631Medicaid
TN3650218Medicare PIN
TN0446631Medicaid