Provider Demographics
NPI:1336917194
Name:ERNST, AMBER (CMT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:ERNST
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8904 LAUREL RDG
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-5203
Mailing Address - Country:US
Mailing Address - Phone:254-239-4681
Mailing Address - Fax:
Practice Address - Street 1:6001 EGAN DR
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-4921
Practice Address - Country:US
Practice Address - Phone:952-440-4553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist