Individual
DR. AMANDA M HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
2900 FRANK SCOTT PKWY W, SUITE 900, BELLEVILLE, IL 62223-5000
(618) 277-5700
(618) 257-7049
Mailing address
2900 FRANK SCOTT PKWY W, SUITE 900, BELLEVILLE, IL 62223-5000
(618) 277-5700
(618) 257-7049
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016.005647
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/14/2012
Last updated
07/07/2015
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