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NPI Code Detail

MEDICARE: MRS. AMY MARIE SCHORTGEN

MEDICARE: MRS. AMY MARIE SCHORTGEN
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
1225XG0600XGerontology Occupational Therapist31003015AIN

General Provider Information

NPI Number : 1326432493
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMY MARIE SCHORTGEN
Provider Business Mailing Address
First Line : 1010 W WASHINGTON CENTER RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-4155
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1010 W WASHINGTON CENTER RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-4155
Country : US
Telephone Number : 260-489-2552
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2015
Last Update Date : 03/26/2015

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