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Individual

DR. AMANDA LENORE BRYANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
5995 KALAMAZOO AVE SE, KENTWOOD, MI 49508-6464
(616) 827-9906
Mailing address
6 ANVIL LN, CALEDONIA, MI 49316-9329
(616) 890-8276

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302033301
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5302033301
PHARMACIST LICENSE
MI
Enumeration date
03/07/2007
Last updated
07/08/2007
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