Healthcare Provider Details

I. General information

NPI: 1457087868
Provider Name (Legal Business Name): AMY ECKERT OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2022
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2776 JANITELL RD
COLORADO SPRINGS CO
80906-4103
US

IV. Provider business mailing address

2776 JANITELL RD
COLORADO SPRINGS CO
80906-4103
US

V. Phone/Fax

Practice location:
  • Phone: 719-332-4689
  • Fax: 719-282-1449
Mailing address:
  • Phone: 719-332-4689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: