Amy Marie Domogalik, PTA is a
Physical Therapy Assistant based in Frankfort, Indiana. Amy Marie Domogalik is licensed to practice in Indiana (license number 06000978A) and her current practice location is
2485 E Wabash St Ste 100, Frankfort, Indiana. She can be reached at her office (for appointments etc.) via phone at
(765) 485-8100.
NPI number for Amy Marie Domogalik is 1295135424 and her current mailing address is 2705 N Lebanon St Ste 305, Lebanon, Indiana. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1295135424.
Healthcare Provider's Profile
Full Name | Amy Marie Domogalik |
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Gender | Female |
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Speciality | Physical Therapy Assistant |
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Location | 2485 E Wabash St Ste 100, Frankfort, Indiana |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1295135424
- Provider Enumeration Date: 08/25/2014
- Last Update Date: 01/03/2019
Medical Identifiers
Medical identifiers for Amy Marie Domogalik such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1295135424 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225100000X | Physical Therapist | 06000978A (Indiana) | Secondary |
225200000X | Physical Therapy Assistant | 06000978A (Indiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amy Marie Domogalik is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Amy Marie Domogalik, PTA 2705 N Lebanon St Ste 305, Lebanon, IN 46052-8622 Ph: (765) 485-8852 | Amy Marie Domogalik, PTA 2485 E Wabash St Ste 100, Frankfort, IN 46041-9400 Ph: (765) 485-8100 |
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