Provider Demographics
NPI:1497633598
Name:CRISTMAN, AMBER J (PTA)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:J
Last Name:CRISTMAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2830 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-5806
Mailing Address - Country:US
Mailing Address - Phone:734-412-4727
Mailing Address - Fax:734-794-3929
Practice Address - Street 1:2830 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-5806
Practice Address - Country:US
Practice Address - Phone:734-412-4727
Practice Address - Fax:734-794-3929
Is Sole Proprietor?:No
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502008049208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation