Doctor Name: | AMY WALLENBURG |
NPI Number: | 1063728509 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.T., M.P.T. |
License Number: | 5501012840 |
Business Practice Address: | 26 N State St Suite 400 Zeeland, MI - 494641281 |
Business Phone Number: | 6167725643 |
Business Fax Number: | 6167725819 |
Mailing Address: | 26 N State St, Suite 400 ZEELAND |
State: | MI |
Postal Code: | 494641281 |
Phone Number: | 6167725643 |
Fax Number: | 6167725819 |
NPI Enumeration Date: | 08/22/2010 |
NPI Last Update Date: | 09/05/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 5501012840 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |