Provider Demographics
NPI:1295938223
Name:STONE, AMY LYNNE (DPT)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:LYNNE
Last Name:STONE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2691 JUNIPER AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-2462
Mailing Address - Country:US
Mailing Address - Phone:303-942-1722
Mailing Address - Fax:
Practice Address - Street 1:2691 JUNIPER AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-2462
Practice Address - Country:US
Practice Address - Phone:303-942-1722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7472174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist