Individual
MRS. AMY ELAINE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
14425 LEO RD, LEO, IN 46765-9407
(260) 615-8219
Mailing address
325 W WALLEN RD, FORT WAYNE, IN 46825-2225
(260) 615-8219
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT21706349
IN
Other
Enumeration date
07/22/2021
Last updated
07/22/2021
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