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Individual

AMANDA WILMOT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
170 COUNTY ROUTE 70, STILLWATER, NY 12170-2103
(518) 316-9952
Mailing address
PO BOX 2249, GANSEVOORT, NY 12831-5249
(518) 316-9952

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
CD47979Q
NY
Enumeration date
02/23/2022
Last updated
02/23/2022
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