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Individual

AMANDA PIMENTEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
24 JOLIET ST, DYER, IN 46311-1705
(219) 322-5747
(219) 864-2282
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085007135
IL
363A00000X
Physician Assistant
Primary
10002289A
IN
363A00000X
Physician Assistant

Other

Enumeration date
05/31/2015
Last updated
06/19/2023
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