Individual
MRS. AMANDA M GROFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
TSSLD
Contact information
Practice address
4479 FREER HOLLOW RD, WALTON, NY 13856-4568
(607) 435-3129
Mailing address
4479 FREER HOLLOW RD, WALTON, NY 13856-4568
(607) 435-3129
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
693379121
NY
Other
Enumeration date
01/04/2013
Last updated
01/04/2013
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