Individual
AMANDA MICHELLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSFA
Contact information
Practice address
520 S EAGLE RD, MERIDIAN, ID 83642-6351
(208) 706-2161
Mailing address
25125 LOWER PLEASANT RIDGE RD, WILDER, ID 83676-5511
(208) 249-6992
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
11/24/2021
Last updated
11/24/2021
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