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Individual
AMANDA FANTRY
Active
Individual
AMANDA FANTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
61342
CT
207X00000X
Orthopaedic Surgery Physician
MD15395
RI
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
61342
CT
Other
Enumeration date
05/20/2011
Last updated
05/25/2021
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