Provider Demographics
NPI:1760855662
Name:HILEMAN, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:HILEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 WAKARUDSA DR
Mailing Address - Street 2:STE 1000
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-1741
Mailing Address - Country:US
Mailing Address - Phone:785-749-1300
Mailing Address - Fax:
Practice Address - Street 1:1311 WAKARUSA DR
Practice Address - Street 2:STE 1000
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-4798
Practice Address - Country:US
Practice Address - Phone:785-749-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-02
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-04398225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant