Provider Demographics
NPI:1598471021
Name:AMBER CROSS DPT, LLC
Entity Type:Organization
Organization Name:AMBER CROSS DPT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:KATRINA
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:541-621-6328
Mailing Address - Street 1:PO BOX 1021
Mailing Address - Street 2:
Mailing Address - City:GOLD HILL
Mailing Address - State:OR
Mailing Address - Zip Code:97525-1021
Mailing Address - Country:US
Mailing Address - Phone:541-621-6328
Mailing Address - Fax:
Practice Address - Street 1:494 HAYES ST
Practice Address - Street 2:
Practice Address - City:GOLD HILL
Practice Address - State:OR
Practice Address - Zip Code:97525-9418
Practice Address - Country:US
Practice Address - Phone:541-621-6328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy