Provider Demographics
NPI:1508176025
Name:PATZLAFF, AMBER M (PT, DPT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:M
Last Name:PATZLAFF
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:M
Other - Last Name:SWANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:11026 422ND AVE
Mailing Address - Street 2:
Mailing Address - City:BRITTON
Mailing Address - State:SD
Mailing Address - Zip Code:57430-5608
Mailing Address - Country:US
Mailing Address - Phone:605-448-2251
Mailing Address - Fax:
Practice Address - Street 1:1131 VANDER HORCK W HWY 10
Practice Address - Street 2:
Practice Address - City:BRITTON
Practice Address - State:SD
Practice Address - Zip Code:57430
Practice Address - Country:US
Practice Address - Phone:605-448-2251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1639225100000X
SD15102251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist