Provider Demographics
NPI:1457546491
Name:RINGSVEN, AMY ECKERSTROM (LPTA)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:ECKERSTROM
Last Name:RINGSVEN
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:CHRISTINE
Other - Last Name:ECKERSTROM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPTA
Mailing Address - Street 1:1660 HIGHWAY 100 S STE 103
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1599
Mailing Address - Country:US
Mailing Address - Phone:763-531-5039
Mailing Address - Fax:
Practice Address - Street 1:9751 REGENT AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-1402
Practice Address - Country:US
Practice Address - Phone:763-315-5340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-12
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3089225200000X
MNA1276225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant