Individual
AMANDA KAY MC CLELLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1615 BEAL RD, MANSFIELD, OH 44903-9171
(419) 564-3085
Mailing address
1615 BEAL RD, MANSFIELD, OH 44903-9171
(419) 564-3085
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.105591-M-IV
OH
Other
Enumeration date
05/28/2011
Last updated
05/28/2011
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