Individual
AMANDA JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1161 CAIN RD, YOUNGSTOWN, NY 14174-9768
(716) 425-0211
Mailing address
1161 CAIN RD, YOUNGSTOWN, NY 14174-9768
(716) 425-0211
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
324705
NY
Other
Enumeration date
05/03/2016
Last updated
05/03/2016
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