Provider Demographics
NPI:1164582003
Name:HAMILTON, AMY KATHRYN (PTA)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:KATHRYN
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MRS
Other - First Name:AMY
Other - Middle Name:KATHRYN
Other - Last Name:STOFFEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:100 COBBLESTONE LN
Mailing Address - Street 2:COURAGE BURNSVILLE
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-4578
Mailing Address - Country:US
Mailing Address - Phone:952-898-5700
Mailing Address - Fax:952-898-5757
Practice Address - Street 1:100 COBBLESTONE LN
Practice Address - Street 2:COURAGE BURNSVILLE
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4578
Practice Address - Country:US
Practice Address - Phone:952-898-5700
Practice Address - Fax:952-898-5757
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant