Provider Demographics
NPI:1255163945
Name:PFROMM, AMBER JO (PTA)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:JO
Last Name:PFROMM
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4446 WARD RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48461-8905
Mailing Address - Country:US
Mailing Address - Phone:810-358-3712
Mailing Address - Fax:
Practice Address - Street 1:1085 S LINDEN RD STE 100
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3416
Practice Address - Country:US
Practice Address - Phone:810-262-2350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502008544208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation