Individual
AMBER ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2103 GORNTO RD, VALDOSTA, GA 31602-2217
(229) 834-4638
Mailing address
2103 GORNTO RD, VALDOSTA, GA 31602-2217
(229) 834-4638
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
02/10/2021
Last updated
02/10/2021
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