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Individual
AMANDA IRENE MAIN
Active
Individual
AMANDA IRENE MAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
027177
NY
363A00000X
Physician Assistant
Primary
PAT9108927
FL
Other
Enumeration date
09/15/2015
Last updated
02/02/2024
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