MEDICARE: AMBER CORMIER DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist		TN

General Provider Information

NPI Number	:	1386381051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER CORMIER DPT

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-238-7568
Fax Number	:

Provider Business Practice Location Address
First Line	:	3849 DAYTON BLVD STE 109
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37415-4044
Country	:	US
Telephone Number	:	423-877-5817
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2022
Last Update Date	:	05/16/2022

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Directions to “ AMBER CORMIER DPT” Practice Location

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