Individual
AMANDA BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
MIMOSA AT GORDON AVENUE, THOMASVILLE, GA 31792
(386) 697-9386
Mailing address
106 MOSS TRL, THOMASVILLE, GA 31792-1670
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
90517
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2018
Last updated
01/06/2023
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