Individual
AMANDA MARIE MINERVINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
5357 S BAKER ST, MURRAY, UT 84107-6374
(973) 479-0136
Mailing address
5357 S BAKER ST, MURRAY, UT 84107-6374
(973) 479-0136
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
122390029934
UT
152W00000X
Optometrist
27OA695800
NJ
Other
Enumeration date
06/19/2020
Last updated
10/10/2023
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