Individual
AMANDA CHANTELL ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7801 OLD BRANCH AVE, UNIT 300 #13, CLINTON, MD 20735
(301) 381-1666
Mailing address
7801 OLD BRANCH AVE, UNIT 300 #13, CLINTON, MD 20735
(301) 381-1666
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82-1428313
PROSTHETIC/ORTHOTIC SUPPLIER
MD
Enumeration date
02/27/2023
Last updated
02/27/2023
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