MEDICARE: MRS. AMY LOUISE BRIGHTMAN M.S.P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	02817	IA

General Provider Information

NPI Number	:	1619957743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMY LOUISE BRIGHTMAN M.S.P.T.

Provider Business Mailing Address
First Line	:	1427 S WASHINGTON BLVD
Second Line	:
City	:	CAMANCHE
State	:	IA
Zip	:	52730-1707
Country	:	US
Telephone Number	:	563-259-4440
Fax Number	:	563-259-1098

Provider Business Practice Location Address
First Line	:	1427 S WASHINGTON BLVD
Second Line	:
City	:	CAMANCHE
State	:	IA
Zip	:	52730-1707
Country	:	US
Telephone Number	:	563-259-4440
Fax Number	:	563-259-1098

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2006
Last Update Date	:	04/20/2022

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