Provider Demographics
NPI:1467403626
Name:VANDER LINDEN, AMY ELIZABETH (PT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ELIZABETH
Last Name:VANDER LINDEN
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 1:4925 W BELL RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-3427
Mailing Address - Country:US
Mailing Address - Phone:602-789-6753
Mailing Address - Fax:602-789-6755
Practice Address - Street 1:4925 W BELL RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-3427
Practice Address - Country:US
Practice Address - Phone:602-789-6753
Practice Address - Fax:602-789-6755
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ109208Medicare PIN