Individual
AMANDA DANIELSON BRODIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9 HAWTHORNE PARK CT, GREENVILLE, SC 29615
(864) 603-5600
(864) 603-5601
Mailing address
525 VERDAE BLVD, SUITE 200, GREENVILLE, SC 29607-4021
(864) 603-5600
(864) 603-5601
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1693
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1274PA
—
SC
Enumeration date
10/11/2011
Last updated
06/14/2018
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