IndividualActive
Amanda Meyers Broughton, PTA
NPI 1194087056 · Physical Therapy Assistant · Canton, IL
Provider details
- NPI number
- 1194087056
- Entity type
- Individual
- Primary specialty
- Physical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PTA
- Sex
- Female
- Sole proprietor
- No
- License
- 160005459 (IL)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
865 N Main St
Canton, IL 61520-1264
Phone: (309) 649-1572
Approximate (ZIP-level) locationGet directions
Mailing address
865 N Main St
Canton, IL 61520-1264
Registry dates
- Enumerated
- 2012-06-15
- Last updated
- 2012-06-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.