Provider Demographics
NPI:1629013461
Name:CHADWICK, AMBER MARIE (OT)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:MARIE
Last Name:CHADWICK
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:C
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:231 GRANITE RUN DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-6823
Mailing Address - Country:US
Mailing Address - Phone:717-560-4200
Mailing Address - Fax:717-560-4159
Practice Address - Street 1:231 GRANITE RUN DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6823
Practice Address - Country:US
Practice Address - Phone:717-735-3600
Practice Address - Fax:717-735-3604
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC010748225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA12892D1XMedicare PIN