Individual
MS. AMANDA MADRID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
220 MILLPOND, STANSBURY PARK, UT 84074-9745
(435) 843-3096
Mailing address
1603 W BRIGADOON PARK DR, WEST JORDAN, UT 84088-6598
(801) 647-9278
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10097228-1206
UT
Other
Enumeration date
09/26/2016
Last updated
11/18/2021
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