Individual
DR. AMANDA ROSE HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
6505 CONSTITUTION BLVD STE C, PORTAGE, MI 49024-1605
(269) 762-4120
(269) 254-8413
Mailing address
6505 CONSTITUTION BLVD STE C, PORTAGE, MI 49024-1605
(269) 762-4120
(269) 254-8413
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101016723
MI
Other
Enumeration date
06/11/2007
Last updated
01/06/2025
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