Provider Demographics
NPI:1093131914
Name:KRUMHOLTZ, AMBER LEIGH (DPT)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:LEIGH
Last Name:KRUMHOLTZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:AMBER
Other - Middle Name:LEIGH
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:2909 SAWTIMBER TRL
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-9405
Mailing Address - Country:US
Mailing Address - Phone:817-937-4073
Mailing Address - Fax:
Practice Address - Street 1:2909 SAWTIMBER TRL
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-9405
Practice Address - Country:US
Practice Address - Phone:817-937-4073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-16
Last Update Date:2014-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11988802251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics