Provider Demographics
NPI:1942582127
Name:HARTMAN, AMY MILES
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:MILES
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:MILES
Other - Last Name:GORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2900 S UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-6029
Mailing Address - Country:US
Mailing Address - Phone:303-773-1034
Mailing Address - Fax:303-773-1034
Practice Address - Street 1:2600 S ROCK CREEK PKWY
Practice Address - Street 2:#36-202
Practice Address - City:SUPERIOR
Practice Address - State:CO
Practice Address - Zip Code:80027-4498
Practice Address - Country:US
Practice Address - Phone:614-989-6303
Practice Address - Fax:614-989-6303
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3141225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist