Provider Demographics
NPI:1568821106
Name:SLUSHER, AMBER (PTA)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:SLUSHER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 W SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45882-9026
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 MYERS RD
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822-1137
Practice Address - Country:US
Practice Address - Phone:419-586-6645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA 05111225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant