Individual
AMANDA SUMMERVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1963 E PRATER WAY STE 101, SPARKS, NV 89434-8938
(775) 636-6269
Mailing address
1963 E PRATER WAY STE 101, SPARKS, NV 89434-8938
(775) 636-6269
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/06/2021
Last updated
10/06/2021
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