Provider Demographics
NPI:1730208349
Name:REAM, AMY LYNN (AT,C)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LYNN
Last Name:REAM
Suffix:
Gender:F
Credentials:AT,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9061 KIMBERLY LN
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-9630
Mailing Address - Country:US
Mailing Address - Phone:231-947-1459
Mailing Address - Fax:
Practice Address - Street 1:3643 W FRONT ST
Practice Address - Street 2:SUITE B
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-7759
Practice Address - Country:US
Practice Address - Phone:231-935-0590
Practice Address - Fax:231-935-0599
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer