Individual
MISS AMANDA E WARDLEIGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDC
Contact information
Practice address
1ST MEDICAL BATTALION, CAMP PENDLETON, CA 92055-5657
(760) 725-2276
Mailing address
5426 ROCKING HORSE LN, OCEANSIDE, CA 92057-5512
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
01/21/2011
Last updated
01/21/2011
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