Provider Demographics
NPI:1821294448
Name:YUILL, AMBER DAWN (ATC)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:DAWN
Last Name:YUILL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
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Mailing Address - Street 1:6510 S MEMORIAL DR
Mailing Address - Street 2:UNIT C
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-3854
Mailing Address - Country:US
Mailing Address - Phone:918-459-6905
Mailing Address - Fax:918-631-3057
Practice Address - Street 1:600 S COLLEGE AVE
Practice Address - Street 2:REYNOLDS CENTER-ATHLETIC TRAINING ROOM
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-3126
Practice Address - Country:US
Practice Address - Phone:918-631-3406
Practice Address - Fax:918-631-3057
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK4512255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer