Individual
AMANDA LEE RADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4150 LARK ST, FAIRFIELD, OH 45014-5780
(513) 348-9010
Mailing address
4150 LARK ST, FAIRFIELD, OH 45014-5780
(513) 348-9010
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
170305.MEDS-IV
OH
Other
Enumeration date
03/11/2020
Last updated
03/11/2020
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