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Individual

MRS. AMANDA IBANEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5852 SUMMER PLACE DR, SYLVANIA, OH 43560-4245
(419) 304-1103
Mailing address
5852 SUMMER PLACE DR, SYLVANIA, OH 43560-4245
(419) 304-1103

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.372680
OH

Other

Enumeration date
12/16/2020
Last updated
12/16/2020
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