Individual
AMANDA LEE SIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
720 SUGAR CREEK RD, WEBSTER SPRINGS, WV 26288-8581
(304) 847-2717
Mailing address
148 SKELT RD, WEBSTER SPRINGS, WV 26288-8470
(304) 402-4042
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
01/05/2021
Last updated
01/05/2021
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