Provider Demographics
NPI:1407095748
Name:VOLK, AMBER RAE (PT)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:RAE
Last Name:VOLK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 S SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-3022
Mailing Address - Country:US
Mailing Address - Phone:218-998-7309
Mailing Address - Fax:
Practice Address - Street 1:824 S SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-3022
Practice Address - Country:US
Practice Address - Phone:218-998-7309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1504225100000X
MN8952225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND12229OtherBCBS ND
ND52114Medicaid
ND356513Medicare PIN