Individual
AMANDA LEE CUSANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4603 STATE ROUTE 193, KINGSVILLE, OH 44048-9722
(440) 224-0866
Mailing address
4603 STATE ROUTE 193, KINGSVILLE, OH 44048-9722
(440) 224-0866
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN-102299
OH
Other
Enumeration date
01/18/2010
Last updated
01/18/2010
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