Individual
MISS AMY BLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1400 MEDICAL PARK DR, FORT WAYNE, IN 46825-5832
(260) 484-1558
Mailing address
1400 MEDICAL PARK DR, FORT WAYNE, IN 46825-5832
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06003313A
IN
Other
Enumeration date
05/07/2026
Last updated
05/07/2026
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