Provider Demographics
NPI:1497051452
Name:TIMPE, AMY M (DPT)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:M
Last Name:TIMPE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2124 PAULINE BLVD
Mailing Address - Street 2:#207
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-5193
Mailing Address - Country:US
Mailing Address - Phone:701-430-1606
Mailing Address - Fax:
Practice Address - Street 1:14265 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-4585
Practice Address - Country:US
Practice Address - Phone:734-525-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-08
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501016343225100000X
MD23563225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist