Provider Demographics
NPI:1366810186
Name:HOERNER, AMY SUE
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:SUE
Last Name:HOERNER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:SUE
Other - Last Name:SABERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:8394 KEMP CT
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52003-9721
Mailing Address - Country:US
Mailing Address - Phone:563-582-6735
Mailing Address - Fax:
Practice Address - Street 1:1400 EASTSIDE RD
Practice Address - Street 2:
Practice Address - City:PLATTEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53818-9800
Practice Address - Country:US
Practice Address - Phone:608-348-2331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-10
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI921-19225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant