Provider Demographics
NPI:1023208709
Name:CHENOWETH, AMBER LYNN (PT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:LYNN
Last Name:CHENOWETH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:LYNN
Other - Last Name:MAJERUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3687 VETERANS DR
Mailing Address - Street 2:
Mailing Address - City:FORT HARRISON
Mailing Address - State:MT
Mailing Address - Zip Code:59636-9703
Mailing Address - Country:US
Mailing Address - Phone:406-447-7708
Mailing Address - Fax:406-447-6791
Practice Address - Street 1:3687 VETERANS DR
Practice Address - Street 2:
Practice Address - City:FORT HARRISON
Practice Address - State:MT
Practice Address - Zip Code:59636-9703
Practice Address - Country:US
Practice Address - Phone:406-447-7708
Practice Address - Fax:406-447-6791
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2178225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8867082Medicare PIN