Individual
AMANDA COLYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2700 FARMINGTON AVE STE 1, FARMINGTON, NM 87401-4559
(505) 609-6380
Mailing address
PO BOX 844088, DALLAS, TX 75284-4088
(505) 609-2258
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
—
—
363A00000X
Physician Assistant
Primary
PA2023-0287
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2013
Last updated
03/18/2025
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