Provider Demographics
NPI:1659529923
Name:BEFORT, AMBER DEE (PT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:DEE
Last Name:BEFORT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:DEE
Other - Last Name:BURKLUND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:504 WEST ST
Mailing Address - Street 2:
Mailing Address - City:RILEY
Mailing Address - State:KS
Mailing Address - Zip Code:66531-9556
Mailing Address - Country:US
Mailing Address - Phone:785-317-2189
Mailing Address - Fax:
Practice Address - Street 1:612 3RD ST
Practice Address - Street 2:
Practice Address - City:LINN
Practice Address - State:KS
Practice Address - Zip Code:66953-9052
Practice Address - Country:US
Practice Address - Phone:785-348-5634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-03847225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist