Individual
MS. AMANDA KAY HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
160 E POPLAR ST STE A, FAYETTEVILLE, AR 72703-2574
(479) 790-3559
Mailing address
160 E POPLAR ST STE A, FAYETTEVILLE, AR 72703-2574
(479) 790-3559
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6304
AR
Other
Enumeration date
12/08/2012
Last updated
12/08/2012
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