Individual
AMANDA THOBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2627 PAUL E MALONE RD, GRAFTON, WV 26354-7141
(304) 771-7887
Mailing address
2627 PAUL E MALONE RD, GRAFTON, WV 26354-7141
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/22/2019
Last updated
04/08/2022
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