Individual
AMANDA MEYERS BROUGHTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
865 N MAIN ST, CANTON, IL 61520-1264
(309) 649-1572
Mailing address
865 N MAIN ST, CANTON, IL 61520-1264
(309) 649-1572
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160005459
IL
Other
Enumeration date
06/15/2012
Last updated
06/15/2012
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