Individual
AMANDA IRENE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
647 N BROAD STREET EXT STE 204, GROVE CITY, PA 16127-4604
(724) 458-6245
(724) 458-6244
Mailing address
PO BOX 16008, PITTSBURGH, PA 15242-0008
(412) 929-0254
(412) 920-5861
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
SC007161
PA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/09/2018
Last updated
03/04/2024
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