Individual
MRS. AMY JO BIEDENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT MHS
Contact information
Practice address
11143 PARKVIEW PLAZA DR STE 100, FORT WAYNE, IN 46845-1728
(260) 266-7400
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
(260) 266-6013
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05008196A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000345430
ANTHEM BCBS
IN
01
—
1424
PHP
IN
01
—
156572
MEDICARE
IN
05
—
200476530A
—
IN
01
—
35179001202
CARESOURCE
IN
01
—
4423623
AETNA
IN
01
—
N285555
HARMONY
IN
Enumeration date
12/08/2006
Last updated
03/01/2021
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