Provider Demographics
NPI:1023318128
Name:MUNDIS, AMY LYNNE (PTA)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LYNNE
Last Name:MUNDIS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1801 FOLKEMER CIR
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-1771
Mailing Address - Country:US
Mailing Address - Phone:717-764-9994
Mailing Address - Fax:717-650-1140
Practice Address - Street 1:1801 FOLKEMER CIR
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404-1771
Practice Address - Country:US
Practice Address - Phone:717-764-9994
Practice Address - Fax:717-650-1140
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE000973L225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant