Individual
MRS. AMANDA BROOKE CANCILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13450 N MERIDIAN ST STE 145, CARMEL, IN 46032-1484
(317) 679-4209
Mailing address
9540 NORA LN, INDIANAPOLIS, IN 46240-1234
(317) 679-4209
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
03/21/2023
Last updated
03/21/2023
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