Individual
AMANDA LYNN GRUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
275 W 12TH ST, PERU, IN 46970
(765) 475-2160
Mailing address
600 E. 12TH ST, ROCHESTER, IN 46075
(574) 835-0991
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06004466A
IN
Other
Enumeration date
08/16/2012
Last updated
08/16/2012
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