Individual
AMANDA VIDAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9500 EUCLID AVE, E-19, CLEVELAND, OH 44195-0001
(216) 636-2174
Mailing address
9500 EUCLID AVE, E-19, CLEVELAND, OH 44195-0001
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
10463
OH
Other
Enumeration date
02/26/2009
Last updated
02/26/2009
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