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Individual

AMANDA RAINELLI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1609 SPANGLER RD NE, CANTON, OH 44714-1656
(330) 458-0276
Mailing address
1609 SPANGLER RD NE, CANTON, OH 44714-1656
(330) 458-0276

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
2661598
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2661598
STATE PROVIDER NUMBER
OH
Enumeration date
04/10/2012
Last updated
04/10/2012
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