Provider Demographics
NPI:1710268073
Name:BOATRIGHT, AMBER LEIGH (DPT)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:LEIGH
Last Name:BOATRIGHT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 PLANT AVE
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31501-5231
Mailing Address - Country:US
Mailing Address - Phone:912-705-4000
Mailing Address - Fax:912-705-4001
Practice Address - Street 1:37 TIPPINS ST
Practice Address - Street 2:SUITE A
Practice Address - City:BAXLEY
Practice Address - State:GA
Practice Address - Zip Code:31513-0595
Practice Address - Country:US
Practice Address - Phone:912-705-4000
Practice Address - Fax:912-705-4001
Is Sole Proprietor?:No
Enumeration Date:2011-08-31
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT009697225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1710268073OtherBCBS