Provider Demographics
NPI:1538299136
Name:TOOKE, AMY ERDALL (ATC)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:ERDALL
Last Name:TOOKE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:NICOLE
Other - Last Name:ERDALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:1409 PALMER ST
Mailing Address - Street 2:
Mailing Address - City:MILES CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59301-3607
Mailing Address - Country:US
Mailing Address - Phone:406-951-4826
Mailing Address - Fax:
Practice Address - Street 1:2600 WILSON ST
Practice Address - Street 2:HOLY ROSARY HEALTHCARE
Practice Address - City:MILES CITY
Practice Address - State:MT
Practice Address - Zip Code:59301-5094
Practice Address - Country:US
Practice Address - Phone:406-233-2719
Practice Address - Fax:406-233-3027
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
MT225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant