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Individual

AMANDA RAE POREMBA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MOT

Contact information

Practice address
1052 MAPLE DR, MORGANTOWN, WV 26505-2815
(304) 599-2600
Mailing address
525 ASPEN ST, MORGANTOWN, WV 26505-2331
(304) 685-7048

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
LPT 370
WV

Other

Enumeration date
10/02/2013
Last updated
10/02/2013
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