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MRS. AMANDA MICHELLE WIPFLI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
403 MALLARD LN, TAYLOR, TX 76574-1210
(512) 352-4000
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1087017
TX
363LF0000X
Family Nurse Practitioner
Primary
1087017
TX

Other

Enumeration date
04/01/2022
Last updated
10/26/2022
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