Provider Demographics
NPI:1982126751
Name:CORNS, AMBER TRIPLETT (MS, ATC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:TRIPLETT
Last Name:CORNS
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 MAPLE LEAF RD
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:VA
Mailing Address - Zip Code:24165-3418
Mailing Address - Country:US
Mailing Address - Phone:276-806-1615
Mailing Address - Fax:
Practice Address - Street 1:351 COMMONWEALTH BLVD E
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-1917
Practice Address - Country:US
Practice Address - Phone:276-403-5870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260033362255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer