Individual
AMANDA ANDREWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
660 S 2ND W, REXBURG, ID 83440-2300
(208) 356-0220
Mailing address
660 S 2ND W, REXBURG, ID 83440-2300
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT-707
ID
Other
Enumeration date
02/05/2014
Last updated
02/05/2014
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