Individual
AMY DEEN VANDESTEEG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
6413 SW 13 ST., GAINESVILLE, FL 32608
(904) 864-3147
Mailing address
22433 NW 94TH AVE, ALACHUA, FL 32615-5915
(904) 864-3147
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
MA 52714
FL
Other
Enumeration date
01/08/2010
Last updated
01/08/2010
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