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Individual

AMANDA WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1743 STATE ROUTE 553, CROWN CITY, OH 45623-9284
(740) 208-0569
Mailing address
1743 STATE ROUTE 553, CROWN CITY, OH 45623-9284
(740) 208-0569

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2704096
OH
Enumeration date
11/23/2020
Last updated
11/23/2020
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