Individual
AMANDA RAE DALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1128 PARK AVE NW, NORTON, VA 24273-1720
(276) 679-4362
Mailing address
1128 PARK AVE NW, NORTON, VA 24273-1720
(276) 679-4362
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0000043877
TN
183500000X
Pharmacist
Primary
0202210055
VA
Other
Enumeration date
11/19/2020
Last updated
11/19/2020
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