Individual
MRS. AMANDA MAE WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
38 STATE STREET, TULLY, NY 13159-0123
(607) 232-2961
Mailing address
PO BOX 123, TULLY, NY 13159-0123
(607) 232-2961
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/16/2011
Last updated
03/16/2011
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