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Individual

AMANDA LEE STAPLETON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
115 E GRANADA BLVD STE 1, ORMOND BEACH, FL 32176-6634
(386) 677-5400
(386) 677-5420
Mailing address
115 E GRANADA BLVD STE 1, ORMOND BEACH, FL 32176-6634
(386) 677-5400
(386) 677-5420

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60867
FL

Other

Enumeration date
05/20/2013
Last updated
05/20/2013
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