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Individual

MRS. MANDY MARIE SPENCER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
1001 E 2ND ST, COUDERSPORT, PA 16915-8161
(814) 274-9300
Mailing address
1001 E 2ND ST, COUDERSPORT, PA 16915-8161
(814) 274-9300

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
018456
NY
363A00000X
Physician Assistant
MA055361
PA
363AM0700X
Medical Physician Assistant
MA055361
PA
363AM0700X
Medical Physician Assistant
Primary
OA007224
PA
363AS0400X
Surgical Physician Assistant
C04670
MD

Other

Enumeration date
02/03/2012
Last updated
04/23/2025
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