Individual
AMANDA MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2080 S E ST, SAN BERNARDINO, CA 92408-2773
(909) 433-9300
Mailing address
2080 S E ST, SAN BERNARDINO, CA 92408-2773
(909) 433-9300
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/12/2024
Last updated
08/12/2024
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