Individual
AMANDA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11330 WATER TANK RD, CYNTHIANA, IN 47612-9531
(812) 480-3947
Mailing address
11330 WATER TANK RD, CYNTHIANA, IN 47612-9531
(812) 480-3947
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
Primary
—
IN
Other
Enumeration date
04/01/2024
Last updated
04/01/2024
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