Individual
AMBER TIEDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA, CSCS
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0013593
CO
225200000X
Physical Therapy Assistant
1438
NE
Other
Enumeration date
01/18/2016
Last updated
09/13/2018
Update your record
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