Provider Demographics
NPI:1699014910
Name:HERR, AMBER MARIE (PHYSICAL THERAPIST A)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:MARIE
Last Name:HERR
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST A
Other - Prefix:MS
Other - First Name:AMBER
Other - Middle Name:MARIE
Other - Last Name:SHULLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICAL THERAPY AST
Mailing Address - Street 1:501 4TH ST.
Mailing Address - Street 2:
Mailing Address - City:WILMOT
Mailing Address - State:SD
Mailing Address - Zip Code:57279
Mailing Address - Country:US
Mailing Address - Phone:605-938-4418
Mailing Address - Fax:605-938-4412
Practice Address - Street 1:501 4TH ST.
Practice Address - Street 2:
Practice Address - City:WILMOT
Practice Address - State:SD
Practice Address - Zip Code:57279
Practice Address - Country:US
Practice Address - Phone:605-938-4418
Practice Address - Fax:605-938-4412
Is Sole Proprietor?:No
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0290225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant