Provider Demographics
NPI:1386794295
Name:TRYGGESTAD, AMY LYNN (ATC)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:LYNN
Last Name:TRYGGESTAD
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3163 HIDDEN PL APT 4
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-4938
Mailing Address - Country:US
Mailing Address - Phone:507-250-2353
Mailing Address - Fax:
Practice Address - Street 1:4212 SOUTHTOWN DR
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-2635
Practice Address - Country:US
Practice Address - Phone:715-832-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI833-0392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer