Individual
AMANDA DELORES ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
204 KENMORE ST N, WILSON, NC 27893-1848
(252) 366-3191
(252) 399-1193
Mailing address
2105B FAIRMOUNT AVE, APT B, RICHMOND, VA 23223-5137
(252) 366-3191
(252) 399-1193
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
12/08/2014
Last updated
12/08/2014
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