Individual
AMANDA MARIE WALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3833 COON RAPIDS BLVD NW STE 100, COON RAPIDS, MN 55433-2697
(763) 427-8320
(763) 302-4338
Mailing address
4225 GOLDEN VALLEY RD, GOLDEN VALLEY, MN 55422-4215
(763) 427-8320
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
MN
Other
Enumeration date
03/28/2019
Last updated
05/19/2022
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