Provider Demographics
NPI:1790224582
Name:DAY, AMBER NICOLE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:NICOLE
Last Name:DAY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:NICOLE
Other - Last Name:SHELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-254-5217
Practice Address - Street 1:646 E BROADWAY BLVD
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37760-4900
Practice Address - Country:US
Practice Address - Phone:865-471-6890
Practice Address - Fax:865-475-0847
Is Sole Proprietor?:No
Enumeration Date:2017-02-14
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11201225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist