Provider Demographics
NPI:1851727861
Name:LENHART, AMBER MICHELLE (PT,DPT,AT,ATC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:MICHELLE
Last Name:LENHART
Suffix:
Gender:F
Credentials:PT,DPT,AT,ATC
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:MICHELLE
Other - Last Name:KLOOSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4761 LAKE MICHIGAN DR NW
Mailing Address - Street 2:SUITE A
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49534-6300
Mailing Address - Country:US
Mailing Address - Phone:616-281-1144
Mailing Address - Fax:616-281-1221
Practice Address - Street 1:7169 KALAMAZOO AVE SE
Practice Address - Street 2:SUITE 200
Practice Address - City:CALEDONIA
Practice Address - State:MI
Practice Address - Zip Code:49316-8146
Practice Address - Country:US
Practice Address - Phone:616-827-3010
Practice Address - Fax:616-855-1496
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501016434225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501016434OtherPT LICENSE NUMBER