Individual
AMANDA MANLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1600 E RIVERVIEW AVE, NAPOLEON, OH 43545-9399
(419) 592-4015
Mailing address
2539 THOMAS AVE, BERKLEY, MI 48072-3243
(248) 872-2970
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4351048699
MI
Other
Enumeration date
06/25/2021
Last updated
06/25/2024
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