Individual
AMANDA RUTH PETERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2219 N WATER STREET EXT, UHRICHSVILLE, OH 44683-1049
(330) 447-3263
Mailing address
2262 FILLMANS BOTTOM RD SW, PORT WASHINGTON, OH 43837-9134
(330) 447-3263
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN141408 M IV
OH
Other
Enumeration date
05/09/2012
Last updated
10/25/2013
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