Individual
MRS. AMANDA WALLACE STREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPO
Contact information
Practice address
1 DOCTORS DR, ASHEVILLE, NC 28801
(828) 254-3392
(828) 254-4380
Mailing address
1 DOCTORS DR, ASHEVILLE, NC 28801-4608
(828) 254-3392
(828) 254-4380
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
—
—
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
09/22/2008
Last updated
07/11/2018
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