Individual
AMANDA MEDELLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
959 E LENNON DR, EMORY, TX 75440-5232
(903) 473-4523
Mailing address
959 E LENNON DR, EMORY, TX 75440-5232
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
33816
TX
Other
Enumeration date
09/28/2020
Last updated
09/28/2020
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