Individual
AMANDA ELIZABETH LOUISELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13001 E 17TH PL, AURORA, CO 80045-2570
(303) 724-2680
Mailing address
3240 NORTHDALE LN NW, COON RAPIDS, MN 55448-6700
(763) 226-8679
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
0006448
CO
Other
Enumeration date
04/03/2017
Last updated
04/03/2017
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