Individual
AMANDA LEIGH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
34830 EDDY RD, THERESA, NY 13691-2218
(570) 447-5411
Mailing address
34830 EDDY RD, THERESA, NY 13691-2218
(570) 447-5411
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
012932
NY
Other
Enumeration date
11/14/2008
Last updated
11/14/2008
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