Individual
AMANDA COMBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
202 BEAM LN, POCOLA, OK 74902-2463
(479) 926-0332
Mailing address
202 BEAM LN, POCOLA, OK 74902-2463
(479) 926-0332
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
A004509
AR
Other
Enumeration date
08/11/2015
Last updated
08/11/2015
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