Individual
MS. AMANDA K ONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5334 W NORTHERN AVE STE 325, GLENDALE, AZ 85301-1441
(480) 621-0363
Mailing address
5334 W NORTHERN AVE STE 325, GLENDALE, AZ 85301-1441
(480) 621-0363
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
23245
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23245
MASSAGE THERAPY
AZ
Enumeration date
08/30/2017
Last updated
06/16/2018
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