Provider Demographics
NPI:1285996298
Name:PRATTE, AMY J (PT)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:J
Last Name:PRATTE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:483 N 400 E
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-9707
Mailing Address - Country:US
Mailing Address - Phone:219-331-5165
Mailing Address - Fax:
Practice Address - Street 1:483 N 400 E
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-9707
Practice Address - Country:US
Practice Address - Phone:219-331-5165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05007084A225100000X
MI5501015011225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist