Provider Demographics
NPI:1457520405
Name:STREFF, AMBER ROSE (DC)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:ROSE
Last Name:STREFF
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:ROSE
Other - Last Name:RUTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:20 POWER DRIVE SUITE #1
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51501
Mailing Address - Country:US
Mailing Address - Phone:712-366-1611
Mailing Address - Fax:
Practice Address - Street 1:20 POWER DRIVE SUITE #1
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51501
Practice Address - Country:US
Practice Address - Phone:712-366-1611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1507111N00000X
IA007334111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor