Individual
AMANDA KROESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13140 LAVONDA ST, EASTVALE, CA 92880-0788
(909) 573-4474
Mailing address
13140 LAVONDA ST, EASTVALE, CA 92880-0788
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95244851
CA
Other
Enumeration date
04/12/2021
Last updated
04/12/2021
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