Individual
AMANDA RIDDELL LEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2335 CHURCH ST, SUITE E, ZACHARY, LA 70791-2700
(225) 654-3607
(225) 658-2262
Mailing address
2335 CHURCH ST, SUITE E, ZACHARY, LA 70791-2700
(225) 654-3607
(225) 658-2262
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO.000325
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2345711
—
LA
Enumeration date
06/13/2008
Last updated
01/26/2020
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