Provider Demographics
NPI:1205967882
Name:NOBLE, AMBER G (PT)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:G
Last Name:NOBLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:9578 WOODYS RUN
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-7910
Mailing Address - Country:US
Mailing Address - Phone:231-933-9320
Mailing Address - Fax:231-933-9320
Practice Address - Street 1:1381 S WEST BAY SHORE DR
Practice Address - Street 2:
Practice Address - City:SUTTONS BAY
Practice Address - State:MI
Practice Address - Zip Code:49682-9498
Practice Address - Country:US
Practice Address - Phone:231-271-0375
Practice Address - Fax:231-271-0376
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501004763225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist