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Individual

DR. AMANDA NICOLE COPPEDGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
240 N. LECANTO HWY., LECANTO, FL 34461
(352) 746-2246
Mailing address
240 N LECANTO HWY, LECANTO, FL 34461-9191
(352) 746-2246

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC4215
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001339500
FL
Enumeration date
08/11/2007
Last updated
07/20/2011
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