Individual
AMANDA N LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
16759 MAIN ST, STE. 201, WILDWOOD, MO 63040-1232
(636) 821-1661
(636) 821-1665
Mailing address
16759 MAIN ST, STE. 201, WILDWOOD, MO 63040-1232
(636) 821-1661
(636) 821-1665
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2011005771
MO
Other
Enumeration date
04/19/2011
Last updated
01/18/2017
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