Provider Demographics
NPI:1356618276
Name:LINZA, AMBER LEE (PT, DPT)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LEE
Last Name:LINZA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8678 RUSH CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CANEADEA
Mailing Address - State:NY
Mailing Address - Zip Code:14717-8735
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8678 RUSH CREEK RD
Practice Address - Street 2:
Practice Address - City:CANEADEA
Practice Address - State:NY
Practice Address - Zip Code:14717-8735
Practice Address - Country:US
Practice Address - Phone:585-437-5395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034469225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist