Provider Demographics
NPI:1447359450
Name:AHO, AMY LYNN (RPT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:AHO
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:HOIKKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2325 PLEASON AVE NW
Mailing Address - Street 2:
Mailing Address - City:COKATO
Mailing Address - State:MN
Mailing Address - Zip Code:55321-4010
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2325 PLEASON AVE NW
Practice Address - Street 2:
Practice Address - City:COKATO
Practice Address - State:MN
Practice Address - Zip Code:55321-4010
Practice Address - Country:US
Practice Address - Phone:320-286-5498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4898225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP45691OtherHEALTH PARTNERS
MN12D32AHOtherBLUE CROSS BLUE SHIELD
MN6411539OtherMEDICA
MN616055700Medicaid
MN12D32AHOtherBLUE CROSS BLUE SHIELD