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Individual

MRS. AMANDA F YOUNG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PROVIDER

Contact information

Practice address
8335 MORNING GLORY RD N, JACKSONVILLE, FL 32210-4588
(904) 378-8374
(904) 378-8374
Mailing address
8335 MORNING GLORY RD N, JACKSONVILLE, FL 32210-4588
(904) 378-8374
(904) 378-8374

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
002084700
FL
171W00000X
Contractor
Primary
686761896
FL
171W00000X
Contractor
686761898
FL

Other

Enumeration date
09/13/2010
Last updated
09/13/2010
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