Individual
AMY NIEWALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1450 IMMOKALEE DR, IMMOKALEE, FL 34142-3420
(239) 658-2362
Mailing address
5230 BECKTON RD, AVE MARIA, FL 34142-5035
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS53007
FL
Other
Enumeration date
04/14/2015
Last updated
04/14/2015
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