Individual
AMANDA BROOKE ATHEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10102 COUNTRY CLUB RD SE, CUMBERLAND, MD 21502-8339
(301) 777-2285
Mailing address
PO BOX 1722, CUMBERLAND, MD 21501-1722
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP55304
MD
Other
Enumeration date
11/12/2020
Last updated
11/12/2020
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