Individual
SALLY GANTT AMAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
28490 2ND ST STE B, DAPHNE, AL 36526-7150
(251) 308-9800
Mailing address
PO BOX 7418, SPANISH FORT, AL 36577-7418
(251) 895-7133
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1550
AL
363A00000X
Physician Assistant
PA1550
AL
Other
Enumeration date
04/03/2020
Last updated
01/10/2022
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