Individual
AMANDA DAWN O/BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
214 W 5TH ST, JOPLIN, MO 64801-2598
(417) 782-2917
(417) 782-7038
Mailing address
500 W SUSAN PL, NEOSHO, MO 64850-2896
(417) 439-8343
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2007001110
MO
Other
Enumeration date
07/17/2013
Last updated
07/17/2013
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