Provider Demographics
NPI:1548668924
Name:STRATTON, AMBER (PTA)
Entity type:Individual
Prefix:MISS
First Name:AMBER
Middle Name:
Last Name:STRATTON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8120 HUGH GILL RD
Mailing Address - Street 2:
Mailing Address - City:ADAMS
Mailing Address - State:TN
Mailing Address - Zip Code:37010-4830
Mailing Address - Country:US
Mailing Address - Phone:615-957-3853
Mailing Address - Fax:
Practice Address - Street 1:608 8TH AVE E
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172-2910
Practice Address - Country:US
Practice Address - Phone:615-984-8453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5678225200000X
TX2107250225200000X
VA2306603969225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant