Provider Demographics
NPI:1184004079
Name:FARTHING, AMY (PT, DPT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:FARTHING
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 KENNESAW AVE NW STE 2
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-7928
Mailing Address - Country:US
Mailing Address - Phone:678-685-7270
Mailing Address - Fax:678-503-2807
Practice Address - Street 1:840 KENNESAW AVE NW STE 2
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-7928
Practice Address - Country:US
Practice Address - Phone:678-685-7270
Practice Address - Fax:678-503-2807
Is Sole Proprietor?:No
Enumeration Date:2015-06-04
Last Update Date:2023-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT011202225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist