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NPI Code Detail

MEDICARE: AMBER HARTMAN PTA

MEDICARE: AMBER HARTMAN PTA
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
1225200000XPhysical Therapy Assistant3236-19WI

General Provider Information

NPI Number : 1164176178
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER HARTMAN PTA
Provider Business Mailing Address
First Line : 417 W DAYTON ST APT 102
Second Line :
City : MADISON
State : WI
Zip : 53703-5022
Country : US
Telephone Number : 509-675-8022
Fax Number :
Provider Business Practice Location Address
First Line : 1100 E VERONA AVE
Second Line :
City : VERONA
State : WI
Zip : 53593-8717
Country : US
Telephone Number : 608-845-6601
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2022
Last Update Date : 02/08/2022

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