Provider Demographics
NPI:1205502242
Name:CALHOUN, AMBER NICOLE (DPT)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:NICOLE
Last Name:CALHOUN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:NICOLE
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:130 LETOURNEAU CIRCLE
Mailing Address - Street 2:BUILDING 90311
Mailing Address - City:HURLBURT FIELD AFB
Mailing Address - State:FL
Mailing Address - Zip Code:32544
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:130 LETOURNEAU CIRCLE
Practice Address - Street 2:BUILDING 90311
Practice Address - City:HURLBURT FIELD AFB
Practice Address - State:FL
Practice Address - Zip Code:32544
Practice Address - Country:US
Practice Address - Phone:850-881-4257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA161164022225100000X
FLPT38874225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist