Individual
MISS AMANDA ELIZABETH ROE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
755 CASE RD, BAINBRIDGE, NY 13733-3197
(607) 967-4858
Mailing address
304 MAIN ST, LOT 3, WORCESTER, NY 12197-1930
(607) 434-7422
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
282889-1
NY
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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