Provider Demographics
NPI:1013950369
Name:BOYDEN-HOEKSTRA, AMY MICHELLE (PT)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MICHELLE
Last Name:BOYDEN-HOEKSTRA
Suffix:
Gender:F
Credentials:PT
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Mailing Address - Street 1:7815 3RD ST N
Mailing Address - Street 2:SUITE 203
Mailing Address - City:OAKDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55128-5447
Mailing Address - Country:US
Mailing Address - Phone:952-835-4512
Mailing Address - Fax:952-516-5655
Practice Address - Street 1:6545 FRANCE AVE S
Practice Address - Street 2:SUITE 373
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2131
Practice Address - Country:US
Practice Address - Phone:952-835-4512
Practice Address - Fax:952-516-5655
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2011-05-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN6502225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN126038300Medicaid